Development and Evaluation of an Indigenized Family Acceptance Project for Lakota 2SLGBTQ+ Teens (PHASE III: PILOT RANDOMIZED CONTROLLED TRIAL )

University of Michigan

Summary

Although research documents the concerning rates of mental and behavioral health problems (e.g., substance use/initiation) among Indigenous LGBTQ2S+ youth, there is very little known about how to prevent these deleterious issues that devastate Indigenous communities. The study will include \~40 families (Lakota LGBTQ2S+ youth and caregivers) in Rapid City, SD (20 families (10 FAP; 10 wait-list control) and on the nearby Pine Ridge Indian Reservation (10 FAP; 10 wait-list control). Following the baseline survey, families will be randomly assigned to the treatment or wait-list control. Participants will complete an immediate post-test and 6-month follow-up survey to test the hypotheses that FAP will lead to changes in targets, specifically increases in caregiver accepting behaviors, youth and caregiver connection to Lakota culture, family bonding, and youth future orientation and decreases in caregiver rejecting behaviors, caregiver harsh parenting, and youth internalized homo/bi/transphobia compared to the control condition. We will also examine the hypotheses that there will be reductions in deleterious primary outcomes (depressive symptoms, anxiety symptoms, suicidality) and secondary outcomes (alcohol and drug use/initiation and dating and sexual violence victimization and perpetration) among youth in the treatment conditions compared to the control condition. Additionally, we will assess the acceptability and feasibility of the FAP via program observations, post-session surveys, and exit interviews.

Description

Indigenous LGBTQ2S+ youth experience disproportionately high rates of mental health problems including depression, anxiety, and suicidality as well as related issues such as alcohol and drug initiation/use and dating and sexual violence. Our preliminary research also shows that Lakota LGBTQ2S+ youth and their adult caretakers perceived the Family Acceptance Project (FAP)-a family support approach that seeks to reduce family rejecting behaviors and increase family accepting behaviors in the context of the family's cultural world-as highly acceptable and likely to be impactful in reducing mental…

Eligibility

Age range: 13+ years
Sex: All
Healthy volunteers: Yes

Detailed criteria

Inclusion Criteria: Youth Inclusion Criteria: 1. Identify as 2SLGBTQ+ (and their identity must be known to their participating caregiver) 2. Identify as Indigenous (multiracial youth who are also Indigenous are eligible) 3. Youth should be between the ages of 13 and 18 years old 4. Read and speak English 5. Report moderate to high levels of caregiver/family rejection (as evidenced by agreement on items that assess the presence and frequency of specific family rejecting behaviors \[includes ambivalent and moderately and highly rejecting caregivers\] AND/OR report the absence of supportive/adv…

Interventions

Behavioral
Adapted Lakota Family Acceptance Program
Tiwahe Tewichaglapi ("The Family Loves Them") Program Overview Tiwahe Tewichaglapi is a culturally grounded, family-centered intervention adapted from the Family Acceptance Project® (FAP) to promote caregiver acceptance, respect, support, and family bonding for 2SLGBTQ+ Lakota youth. The program was developed in partnership with the Lakota Oyate to address family rejection rooted in colonization and historical trauma and to honor traditional Two Spirit roles that have long held important and respected places within Lakota communities. The program aims to strengthen families, increase youth pride and hope for the future, and reduce mental health risks such as depression, anxiety, substance use, dating violence, and suicide among 2SLGBTQ+ Lakota youth. The program includes eight family group sessions 2.5 hrs. each delivered by Lakota facilitators that include Lakota cultural and spiritual practices - including smudging, a Lakota prayer, and a shared meal.

Locations (2)

Wahwala Iyohlogya/Peaceful Means
Pine Ridge, South Dakota
University of Michigan
Rapid City, South Dakota

Summary

Description

Eligibility

Age range

13+ years

Sex

All

Healthy volunteers

Yes

Detailed criteria

Interventions

Behavioral

Adapted Lakota Family Acceptance Program

Tiwahe Tewichaglapi ("The Family Loves Them") Program Overview Tiwahe Tewichaglapi is a culturally grounded, family-centered intervention adapted from the Family Acceptance Project® (FAP) to promote caregiver acceptance, respect, support, and family bonding for 2SLGBTQ+ Lakota youth. The program was developed in partnership with the Lakota Oyate to address family rejection rooted in colonization and historical trauma and to honor traditional Two Spirit roles that have long held important and respected places within Lakota communities. The program aims to strengthen families, increase youth pride and hope for the future, and reduce mental health risks such as depression, anxiety, substance use, dating violence, and suicide among 2SLGBTQ+ Lakota youth. The program includes eight family group sessions 2.5 hrs. each delivered by Lakota facilitators that include Lakota cultural and spiritual practices - including smudging, a Lakota prayer, and a shared meal.