Tuned in!: 12-Month Longitudinal Outcomes of an Affirmative Mindfulness Intervention for Sexual and Gender Diverse Youth and Young Adults

Background and Purpose: Sexual and gender diverse youth and young adults (SGDY) are disproportionately affected by mental health disparities due to widespread anti-LGBTQIA+ discrimination and minority stressors. Despite the growing body of research on youth mental health interventions, a critical lack of culturally responsive approaches for SGDY remains. This study addresses this gap by assessing the effectiveness of an LGBTQIA+ affirmative mindfulness-based intervention (MBI), Tuned In!, and ways findings can inform transformative practice, research, and policy.

Utilizing a community-based participatory action research (CBPAR) approach, this open pilot feasibility study tested Tuned In!, co-developed with SGDY and community partners. Tuned In! was designed to promote SGDY mental health by developing coping strategies (e.g., self-advocacy, grounding, assertiveness) to effectively navigate the current sociopolitical context, reduce anxiety, depression, distress, and enhance identity affirmation, sexual self-efficacy, mindfulness, and self-compassion.

Methods: Using purposive sampling, a diverse sample of SGDY participants (n=52), ages 16-29 were recruited in CT. A pre/post, 6 and 12-month follow-up design evaluated changes in mental health outcomes. Measures included: Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, Brief Symptom Inventory, Adolescent Mindfulness Measure, Self-Compassion Scale, Sexual Self-Efficacy Scale, and a satisfaction survey. Tuned In! consisted of eight weekly sessions (90 minutes) and was facilitated by trained licensed clinicians (e.g., LCSW).

A series of two-level hierarchical linear modeling (HLM) analyses were conducted to evaluate the effects of the intervention on the outcomes. These analyses included four waves of repeated observations – baseline, post-intervention, 6-month follow-up, and 12-month follow-up – as Level 1 data and participants as Level 2 data. Both the intercept and slope were treated as random effects in the HLM. Statistical significance was reported at p < 0.05.

Results: Findings indicate high feasibility, acceptability and sustained engagement. Fifty-two SGDY participants (aged 16–29) completed the program, 51 completed post-test survey, 48 completed 6-month, and 44 completed 12-month follow-up survey. Findings show significant and sustained decreases in depression (BDI) (β = −1.30, SE = 0.32, p < 0.001), anxiety (STAI) (β = −1.09, SE = 0.25, p < 0.001), and overall psychological distress (BSI) (β = −0.10, SE = 0.03, p < 0.001) at 12-month post-testing. Results also show sustained and significant increases in sexual self-efficacy (β = 1.72, SE = 0.60, p = 0.004), mindfulness (CAMM) (β = 1.59, SE = 0.33, p < 0.001), and self-compassion (SCS) (β = 0.14, SE = 0.03, p < 0.001) at 12-month post-testing. Participants highly rated Tuned In!, with 95% of participants stating they learned a lot from the program, and 96% indicating they could use the skills learned to manage stress and personal challenges.

Conclusions and Implications: The findings of the study reveal the positive outcomes of the Tuned In! intervention was consistent over a 12-month period, highlighting its potential to be scaled up as an effective intervention, in addition to the importance of CBPAR in developing affirmative and culturally responsive interventions for SGDY. Given the sociopolitical climate, adaptation considerations, particularly for SGDY of color, is crucial in transforming social work practice, policy and research.