BACKGROUND Research suggests that lesbian and bisexual girls are between two and four times more ... more BACKGROUND Research suggests that lesbian and bisexual girls are between two and four times more likely to report having been pregnant than girls who identify as exclusively heterosexual. Despite this compelling evidence that sexual minority adolescent girls are at risk for teen pregnancy, programs tailored to the unique needs of LGB adolescents are nonexistent. OBJECTIVE Research suggests that lesbian and bisexual girls are between two and four times more likely to report having been pregnant than girls who identify as exclusively heterosexual. Despite this compelling evidence that sexual minority adolescent girls are at risk for teen pregnancy, programs tailored to the unique needs of LGB adolescents are nonexistent. METHODS Over a 12-month period between 2015 and 2016, three different formative activities were implemented to develop and refine the prevention program. Participants were 14-18 year-old cisgender females recruited nationally on Facebook and Instagram. First, focus groups (FGs) were conducted to gain teens’ ‘voice’ about how they talked about sexual situations (n=160). Next, content advisory teams (CATs) were convened to iteratively review a draft of the intervention messages and provide feedback on their tone, saliency, and understandability (n=82). Finally, once the content and assessments were finalized, a beta test was conducted to confirm the program functionality, the feasibility of the assessments, and the enrollment protocol (n=27). RESULTS Girls in the FGs were overwhelmingly positive about the idea of receiving text messages about sexual health, although privacy was a noteworthy concern. As such, important safe guards were built into the enrollment process (e.g., the provision of how-to guides to safe-guard one’s phone). Teens in the CATs found the content to be approachable, salient, and educational although many wanted the messages to be more gender inclusive. Messages were thusly updated to not assume people with penises were boys. Once the messages and study protocol were finalized, a beta test was conducted. None of the participants withdrew during the six-week intervention and between 71-86% provided weekly feedback, suggesting both the protocol and content were feasible to test at the national level in a subsequent RCT. CONCLUSIONS This careful step-by-step iterative approach resulted in a high level of feasibility and acceptability, with all randomized beta test participants successfully completing the program. Developed and refined with the input of diverse sexual minority adolescent girls from across the United States, Girl2Girl program is a promising approach to addressing sexual health and pregnancy prevention in this underserved but vulnerable population. CLINICALTRIAL NCT03029962
In recent years, more attention has been given to the fact that grieving is a process, especially... more In recent years, more attention has been given to the fact that grieving is a process, especially in the work of Elizabeth Kubler-Ross. The literature has focused on many aspects of bereavement, including how the process may be different at different ages. Much of the research on adolescents has focused on reactions to the suicide of a peer. The purpose of this study was to explore adolescent reactions to the death of a peer by means other than suicide. Semistructured interviews were conducted with ten college students about their experience of losing a friend in high school. Results indicated that even after a few years, the adolescents were still struggling through the grieving process. Implications for future research and suggestions for practitioners faced with similar crises are offered.
BACKGROUND Lesbian, gay, bisexual, and other sexual minority (LGB+) girls are more likely than he... more BACKGROUND Lesbian, gay, bisexual, and other sexual minority (LGB+) girls are more likely than heterosexual girls to be pregnant during adolescence. Nonetheless, LGB+ inclusive pregnancy prevention programming is lacking. METHODS Between January 2017 and January 2018, 948, 14 to 18 year-old cisgender LGB+ girls were enrolled in a national randomized controlled trial. Girls were assigned either to Girl2Girl or an attention-matched control group. They were recruited via social media and enrolled over the telephone. The 5-month intervention consisted of a 7-week program (4–12 text messages sent daily) and a 1-week booster delivered 12 weeks later. Longitudinal models of protected sex events had a negative binomial distribution and a log link function. Longitudinal models examining use of birth control assumed a Bernoulli distribution of the outcome variable and a logit link function. Models adjusted for baseline rate of the outcome, age, and a time-varying indicator of sexual experience. RESULTS Girl2Girl participants had higher rates of protected penile-vaginal sex events over time compared with controls. Girl2Girl participants also were more likely than control participants to report use of birth control other than condoms. Models of abstinence and pregnancy rates did not suggest statistically significant group differences across time. However, effect sizes were in the small to medium range and point estimates favored Girl2Girl versus control in both cases. CONCLUSIONS Girl2Girl is associated with sustained pregnancy preventive behaviors for LGB+ girls through 12 months postintervention. Text messaging could be considered as a viable method to increase access to sexual health programming to adolescents nationally.
BACKGROUND Lesbian, gay, bisexual, and other sexual minority (LGB+) girls are more likely than he... more BACKGROUND Lesbian, gay, bisexual, and other sexual minority (LGB+) girls are more likely than heterosexual girls to be pregnant during adolescence. Nonetheless, LGB+ inclusive pregnancy prevention programming is lacking. METHODS Between January 2017 and January 2018, 948, 14 to 18 year-old cisgender LGB+ girls were enrolled in a national randomized controlled trial. Girls were assigned either to Girl2Girl or an attention-matched control group. They were recruited via social media and enrolled over the telephone. The 5-month intervention consisted of a 7-week program (4–12 text messages sent daily) and a 1-week booster delivered 12 weeks later. Longitudinal models of protected sex events had a negative binomial distribution and a log link function. Longitudinal models examining use of birth control assumed a Bernoulli distribution of the outcome variable and a logit link function. Models adjusted for baseline rate of the outcome, age, and a time-varying indicator of sexual experienc...
This study assessed relationships between condom availability programs accompanied by community d... more This study assessed relationships between condom availability programs accompanied by community discussion and involvement and adolescent sexual practices. Methods. Sexual practice and condom use differences were assessed in a repre-sentative sample of 4166 adolescents enrolled in high schools with and without con-dom availability programs. Results. Adolescents in schools where condoms were available were more likely to receive condom use instruction and less likely to report lifetime or recent sexual inter-course. Sexually active adolescents in those schools were twice as likely to use con-doms, but less likely to use other contraceptive methods, during their most recent sex-ual encounter. Conclusions. The strategy of making condoms available, an indication of socioenvi-ronmental support for condom use, may improve HIV prevention practices. (Am J Pub-
OBJECTIVE To address the significant dearth of literature that examines how girls who are lesbian... more OBJECTIVE To address the significant dearth of literature that examines how girls who are lesbian, gay, bisexual, or who have another nonheterosexual identity (LGB+) decide when and with whom to have sex; and to explore why inexperienced LGB+ girls might have sex with girls or boys. STUDY DESIGN We conducted 8 online, asynchronous, bulletin board-style focus groups with 160 adolescent girls 14-18 years of age. The transcripts were analyzed using a thematic analysis of each girls' responses to the questions. Analyses were focused on increasing our understanding of sexual health decision making among LGB+ teenage girls (eg, "What was the reason you had sex for the first time?"). Participants' responses reflected their day-to-day experiences and roles of cisgender LGB+ girls inside a dominant heteronormative social structure. RESULTS Some LGB+ girls talked about the perception that LGB+ girls were presumed or expected to be hypersexual, and that they did not feel they could be accepted as LGB+ without being sexually active. Developmental aspects of identity were also salient: Girls considered or engaged in sexual encounters as a way of figuring out to whom they were attracted as well as confirming or disconfirming the identity labels they used for themselves. Same-sex encounters could be offered as "proof" that one really was LGB+. Similarly, unsatisfying experiences with guys could serve as evidence that they were not attracted to guys. CONCLUSION Sexual decision making among LGB+ girls is often driven by aspects of their sexual minority identity.
BACKGROUND Research suggests that lesbian and bisexual girls are between two and four times more ... more BACKGROUND Research suggests that lesbian and bisexual girls are between two and four times more likely to report having been pregnant than girls who identify as exclusively heterosexual. Despite this compelling evidence that sexual minority adolescent girls are at risk for teen pregnancy, programs tailored to the unique needs of LGB adolescents are nonexistent. OBJECTIVE Research suggests that lesbian and bisexual girls are between two and four times more likely to report having been pregnant than girls who identify as exclusively heterosexual. Despite this compelling evidence that sexual minority adolescent girls are at risk for teen pregnancy, programs tailored to the unique needs of LGB adolescents are nonexistent. METHODS Over a 12-month period between 2015 and 2016, three different formative activities were implemented to develop and refine the prevention program. Participants were 14-18 year-old cisgender females recruited nationally on Facebook and Instagram. First, focus groups (FGs) were conducted to gain teens’ ‘voice’ about how they talked about sexual situations (n=160). Next, content advisory teams (CATs) were convened to iteratively review a draft of the intervention messages and provide feedback on their tone, saliency, and understandability (n=82). Finally, once the content and assessments were finalized, a beta test was conducted to confirm the program functionality, the feasibility of the assessments, and the enrollment protocol (n=27). RESULTS Girls in the FGs were overwhelmingly positive about the idea of receiving text messages about sexual health, although privacy was a noteworthy concern. As such, important safe guards were built into the enrollment process (e.g., the provision of how-to guides to safe-guard one’s phone). Teens in the CATs found the content to be approachable, salient, and educational although many wanted the messages to be more gender inclusive. Messages were thusly updated to not assume people with penises were boys. Once the messages and study protocol were finalized, a beta test was conducted. None of the participants withdrew during the six-week intervention and between 71-86% provided weekly feedback, suggesting both the protocol and content were feasible to test at the national level in a subsequent RCT. CONCLUSIONS This careful step-by-step iterative approach resulted in a high level of feasibility and acceptability, with all randomized beta test participants successfully completing the program. Developed and refined with the input of diverse sexual minority adolescent girls from across the United States, Girl2Girl program is a promising approach to addressing sexual health and pregnancy prevention in this underserved but vulnerable population. CLINICALTRIAL NCT03029962
In recent years, more attention has been given to the fact that grieving is a process, especially... more In recent years, more attention has been given to the fact that grieving is a process, especially in the work of Elizabeth Kubler-Ross. The literature has focused on many aspects of bereavement, including how the process may be different at different ages. Much of the research on adolescents has focused on reactions to the suicide of a peer. The purpose of this study was to explore adolescent reactions to the death of a peer by means other than suicide. Semistructured interviews were conducted with ten college students about their experience of losing a friend in high school. Results indicated that even after a few years, the adolescents were still struggling through the grieving process. Implications for future research and suggestions for practitioners faced with similar crises are offered.
BACKGROUND Lesbian, gay, bisexual, and other sexual minority (LGB+) girls are more likely than he... more BACKGROUND Lesbian, gay, bisexual, and other sexual minority (LGB+) girls are more likely than heterosexual girls to be pregnant during adolescence. Nonetheless, LGB+ inclusive pregnancy prevention programming is lacking. METHODS Between January 2017 and January 2018, 948, 14 to 18 year-old cisgender LGB+ girls were enrolled in a national randomized controlled trial. Girls were assigned either to Girl2Girl or an attention-matched control group. They were recruited via social media and enrolled over the telephone. The 5-month intervention consisted of a 7-week program (4–12 text messages sent daily) and a 1-week booster delivered 12 weeks later. Longitudinal models of protected sex events had a negative binomial distribution and a log link function. Longitudinal models examining use of birth control assumed a Bernoulli distribution of the outcome variable and a logit link function. Models adjusted for baseline rate of the outcome, age, and a time-varying indicator of sexual experience. RESULTS Girl2Girl participants had higher rates of protected penile-vaginal sex events over time compared with controls. Girl2Girl participants also were more likely than control participants to report use of birth control other than condoms. Models of abstinence and pregnancy rates did not suggest statistically significant group differences across time. However, effect sizes were in the small to medium range and point estimates favored Girl2Girl versus control in both cases. CONCLUSIONS Girl2Girl is associated with sustained pregnancy preventive behaviors for LGB+ girls through 12 months postintervention. Text messaging could be considered as a viable method to increase access to sexual health programming to adolescents nationally.
BACKGROUND Lesbian, gay, bisexual, and other sexual minority (LGB+) girls are more likely than he... more BACKGROUND Lesbian, gay, bisexual, and other sexual minority (LGB+) girls are more likely than heterosexual girls to be pregnant during adolescence. Nonetheless, LGB+ inclusive pregnancy prevention programming is lacking. METHODS Between January 2017 and January 2018, 948, 14 to 18 year-old cisgender LGB+ girls were enrolled in a national randomized controlled trial. Girls were assigned either to Girl2Girl or an attention-matched control group. They were recruited via social media and enrolled over the telephone. The 5-month intervention consisted of a 7-week program (4–12 text messages sent daily) and a 1-week booster delivered 12 weeks later. Longitudinal models of protected sex events had a negative binomial distribution and a log link function. Longitudinal models examining use of birth control assumed a Bernoulli distribution of the outcome variable and a logit link function. Models adjusted for baseline rate of the outcome, age, and a time-varying indicator of sexual experienc...
This study assessed relationships between condom availability programs accompanied by community d... more This study assessed relationships between condom availability programs accompanied by community discussion and involvement and adolescent sexual practices. Methods. Sexual practice and condom use differences were assessed in a repre-sentative sample of 4166 adolescents enrolled in high schools with and without con-dom availability programs. Results. Adolescents in schools where condoms were available were more likely to receive condom use instruction and less likely to report lifetime or recent sexual inter-course. Sexually active adolescents in those schools were twice as likely to use con-doms, but less likely to use other contraceptive methods, during their most recent sex-ual encounter. Conclusions. The strategy of making condoms available, an indication of socioenvi-ronmental support for condom use, may improve HIV prevention practices. (Am J Pub-
OBJECTIVE To address the significant dearth of literature that examines how girls who are lesbian... more OBJECTIVE To address the significant dearth of literature that examines how girls who are lesbian, gay, bisexual, or who have another nonheterosexual identity (LGB+) decide when and with whom to have sex; and to explore why inexperienced LGB+ girls might have sex with girls or boys. STUDY DESIGN We conducted 8 online, asynchronous, bulletin board-style focus groups with 160 adolescent girls 14-18 years of age. The transcripts were analyzed using a thematic analysis of each girls' responses to the questions. Analyses were focused on increasing our understanding of sexual health decision making among LGB+ teenage girls (eg, "What was the reason you had sex for the first time?"). Participants' responses reflected their day-to-day experiences and roles of cisgender LGB+ girls inside a dominant heteronormative social structure. RESULTS Some LGB+ girls talked about the perception that LGB+ girls were presumed or expected to be hypersexual, and that they did not feel they could be accepted as LGB+ without being sexually active. Developmental aspects of identity were also salient: Girls considered or engaged in sexual encounters as a way of figuring out to whom they were attracted as well as confirming or disconfirming the identity labels they used for themselves. Same-sex encounters could be offered as "proof" that one really was LGB+. Similarly, unsatisfying experiences with guys could serve as evidence that they were not attracted to guys. CONCLUSION Sexual decision making among LGB+ girls is often driven by aspects of their sexual minority identity.
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