Strengthening Family Support for LGBTQ2S+ Youth: A Pilot Study of a Parent Education Video

Background: Lesbian, gay, bisexual, transgender, queer, and two-spirit youth (LGBTQ2S+) are at increased risk for mental and physical illness. Support from family is the most important protective factor for LGBTQ2S+ youth. Given there are few evidence-based interventions to strengthen this support, we created a video of LGBTQ2S+ stories to educate caregivers about methods/impacts of support. The study aimed to 1) gather participant views of the video and pilot survey instrument, and 2) collect preliminary data about the video’s effects on participant knowledge and attitudes.

Methods: Participants were English-speaking caregivers of children seen in a pediatric primary care clinic or recruited via online research site. Participants completed a baseline survey consisting of knowledge questions and anti-LGBTQ2S+ bias score, watched the video, and answered additional questions. Cognitive interviewing assessed participants’ reactions. Participants were sent an optional follow-up survey >1 month later with repeat bias scale, knowledge questions, and feedback box. Interview data were deductively analyzed by two reviewers using Atlas.ti software. Pilot quantitative data was analyzed using two-sample paired t-test for comparison between baseline and follow-up survey.

Results: 29 participants completed the baseline survey, 27 completed post-video survey and interviews, and 15 completed a survey at 1 month. 76% (22) of participants self-identified as female, 51% were older than 35 years, and 43% (12) had an LGBTQ2S+ family member.

Participants were supportive of the video, regardless of their baseline anti-LGBTQ2S+ bias. Respondents felt the video provided language for families to have discussions about gender and sexuality, emphasized the importance of family support, increased awareness of mental health implications, and changed participant perspectives/how they would interact with their children. Many expressed desire to share the video. Criticisms included wanting an increased diversity of stories and feeling scenarios were unrealistic. Respondents felt survey questions were easy to understand, but that knowledge questions were leading and did not reflect reality.

There was a trend toward improvement in anti-LGBTQ2S+ bias scores at 1 month follow-up, although not statistically significant (n=15, p=0.06). Knowledge scores did not change significantly pre-and post video. Individuals with higher baseline anti-LGBTQ2S+ bias total scores more frequently mentioned how generational differences and upbringing impact their current perspectives. Individuals with lower baseline bias scores more commonly mentioned of barriers to family support, including religion, culture, and stigma, and recognition that we all have “some room to grow”.

Conclusion: There was a positive response to the video and pilot survey. Results demonstrated trends towards improvement in anti-LGBTQ2S+ bias scores over time in a small sample size. Feedback will be used to modify the survey instrument and video prior to larger scale randomized trial to assess impact of the video on viewers’ knowledge and attitudes about supporting LGBTQ2S+ youth.