Many lesbian, gay, bisexual, or queer (LGBQ) youth suffer from depression. Identifying modifiable risk and protective factors for depression can inform the development of psychosocial interventions. The aim of this review is to evaluate the methodological characteristics and summarize the substantive findings of studies examining psychosocial risk and protective factors for depression among LGBQ youth. Eight bibliographic databases were searched, and 35 studies that met all inclusion criteria were included for review. Results show that prominent risk factors for depression include internalized LGBQ-related oppression, stress from hiding and managing a socially stigmatized identity, maladaptive coping, parental rejection, abuse and other traumatic events, negative interpersonal interactions, negative religious experiences, school bullying victimization, and violence victimization in community settings. Prominent protective factors include a positive LGBQ identity, self-esteem, social support from friends, and family support. LGBQ youth may face an array of threats to their mental health originating from multiple socioecological levels.

This paper is a systematic review and meta-analysis on sexual orientation identity development milestones among people who are lesbian, gay, bisexual, or another sexual minority identity (LGB+). Common milestones measured in the 30 studies reviewed were becoming aware of queer attractions, questioning one’s sexual orientation, self-identifying as LGB+, coming out to others, engaging in sexual activity, and initiating a romantic relationship. Milestones occurred in different sequences, although attraction was almost always first, often followed by self-identification and/or sexual activity; coming out and initiating a romantic relationship often followed these milestones. Meta-analysis results showed that the mean effect sizes and 95% confidence intervals varied by milestone: attraction [M_age=12.7 (10.1, 15.3)], questioning one’s orientation [M_age=13.2 [12.8, 13.6]), self-identifying [M_age=17.8 (11.6, 24.0)], sexual activity [M_age=18.1 (17.6, 18.6)], coming out [M_age=19.6 (17.2, 22.0)], and romantic relationship [M_age=20.9 (13.2, 28.6)]. Nonetheless, results also showed substantial heterogeneity in the mean effect sizes. Additional meta-analyses showed that milestone timing varied by sex, sexual orientation, race/ethnicity, and birth cohort. Although patterns were found in LGB+ identity development, there was considerable diversity in milestone trajectories.

Objective: Bullying threatens the mental and educational well-being of students. Although anti-bullying policies are prevalent, little is known about their effectiveness. This systematic re...

Process evaluation is an assessment of the implementation of an intervention. A process evaluation component was embedded in the HEALTHY study, a primary prevention trial for Type 2 diabetes implemented over 3 years in 21 middle schools across the United States. The HEALTHY physical education (PE) intervention aimed at maximizing student engagement in moderate-to-vigorous physical activity through delivery of structured lesson plans by PE teachers. Process evaluation data collected via class observations and interventionist interviews assessed fidelity, dose delivered, implementor participation, dose received and barriers. Process evaluation results indicate a high level of fidelity in implementing HEALTHY PE activities and offering 225 min of PE every 10 school days. Concerning dose delivered, students were active for approximately 33 min of class, representing an average of 61% of the class time. Results also indicate that PE teachers were generally engaged in implementing the HEALTHY PE curriculum. Data on dose received showed that students were highly engaged with the PE intervention; however, student misbehavior was the most common barrier observed during classes. Other barriers included teacher disengagement, large classes, limited gym space and poor classroom management. Findings suggest that the PE intervention was generally implemented and received as intended despite several barriers.

Depression disproportionately affects LGBTQ (lesbian, gay, bisexual, transgender, or queer) adolescents and young adults. Cognitive behavioral therapy (CBT) is an evidence-based treatment approach; however, there has been limited work to adapt and evaluate CBT with LGBTQ young people. This study examined the feasibility of an intervention called Being Out With Strength (BOWS), which is an 8-session, small-group, CBT-based intervention to reduce depression among LGBTQ young people. We used a descriptive cross-sectional mixed-methods feasibility study design to evaluate the feasibility of BOWS. Survey data were collected from 79 LGBTQ young adults, and interview data were collected from nine mental health professionals. Almost half of the young adults had clinically significant depressive symptoms. All providers indicated depression as a problem facing this population and a need for BOWS. Two-thirds of young people were interested in participating in BOWS. Providers believed that BOWS would be acceptable for LGBTQ-identified individuals, those in late adolescence or early/young adulthood, and those with mild or moderate depression. Youth and providers also made implementation recommendations concerning settings to implement BOWS, times of day for BOWS sessions, number of sessions, group size, and facilitator composition. There is a demand for BOWS, and it is likely acceptable for the target population. Study findings can be used in the future to successfully implement BOWS and evaluate preliminary efficacy.