An online intervention to support the mental wellbeing of sexual and gender minority young people in England: Co-design of ‘Oneself'

Brown, Katherine E.; Lucassen, Mathijs F. G.; Núñez-García, Alicia; Rimes, Katharine A.; Wallace, Louise M. and Samra, Rajvinder (2024). An online intervention to support the mental wellbeing of sexual and gender minority young people in England: Co-design of ‘Oneself'. JMIR formative research (in press).

Abstract

Introduction
Sexual and gender minority youth (SGMY) are known to be at greater risk of compromised mental health when compared with their heterosexual and cisgender peers. This is considered to be due to an increased burden from stigma, discrimination, or victimisation resulting in the heightened experience of stress in their daily lives. Given increasing digital accessibility and a strong preference for support online amongst SGMY, digital interventions are a keyway to provide support to manage stress and maintain SGMY wellbeing. This paper aims to explicate the codesign processes and underpinning logic of Oneself, a bespoke online intervention for SGMY.
Methods
The research followed a six-stage process set out by Hagen and colleagues (Identify, Define, Position, Concept, Create, Use) incorporating: a systematic scoping review of existing evidence; focus groups with four stakeholder groups (i.e., SGMY, professionals who directly support SGMY, parents of SGMY, and UK public health service commissioners); a series of co-design workshops and online consultations with SGMY; the appointment of a digital development company; and young adult SGM contributors to create content that was grounded in authentic SGMY experiences.
Results
Oneself features a welcome/home page that includes a free ‘accessible to all’ animation explaining the importance of using appropriate pronouns, and the opportunity to create a user account and log-in to access further free content. Creating a user account provides an opportunity (for the user and the research team) to record engagement, assess users’ wellbeing and track progress through the available content. There are three sections of content in Oneself focussed on the priority topics identified through co-design; 1. coming out and doing so safely, 2. managing school, including homophobic, biphobic or transphobic bullying or similar, and 3. dealing with parents and families, especially unsupportive family members, including parents/caregivers. Oneself’s content focuses on identifying these as topic areas and providing potential resources to assist SGMY cope with these areas. For instance, Oneself drew on therapeutic concepts such as cognitive reframing, stress reduction and problem-solving techniques. There is also a section containing relaxation exercises, a section with links to other recommended support and resources, and a ‘downloads’ section with more detailed techniques and strategies for improving wellbeing.
Discussion
This paper contributes to research by opening up the ‘black box’ of intervention development. It shows how Oneself is underpinned by a logic which can support future development/evaluation and included diverse co-designers. More interactive techniques to support wellbeing would be a beneficial addition in further development. Additional content specific to a wider range of intersecting identities (such as being a care experienced Asian SGMY from a minority faith background) would also be beneficial in future Oneself development.

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