Trial Outcomes & Findings for The BH-Works Suicide Prevention Program for Sexual and Gender Minority Youth (NCT NCT05922670)

We enrolled staff and administrators (n=18) across participating LGBTQ sites and their behavioral health partners. Enrollment occurred between July 2024 and February 2025. Baseline characteristics were assessed for those who completed pre-training assessments (n=17). Training outcomes were assessed for those who completed all training activities and post-training assessments (n=15).

No participants were slated to be randomized in this study. All administrator and staff participants were enrolled in the same condition (SGM BH-Works staff training). This study was designed to include youth and caregiver participants as well as administrator and staff participants; however, no youth or caregiver participants were enrolled prior to study termination.

Respondents who indicated "I don't know" or "I prefer not to answer" on this item are not included in the mean.

Youth and staff report (medical records) indicate that the youth has attended a first behavioral health appointment at the behavioral health site that LGBTQ organization staff referred them to. This data is to be recorded dichotomously (no= 0; yes=1).

The Acceptability of Intervention Measure (AIM) examine intervention or program acceptability. Youth will complete this measure within one week to one month after they enroll in the study and complete the behavioral health screen. The AIM includes 4-items and has a 5-point Likert response scale (1 = completely disagree, 5 = completely agree) for each item. To calculate the total scale score for the measure, responses from the 4-items are averaged for a total score of 1-5. Higher scores indicate greater program satisfaction.

LGBTQ organization staff will indicate whether a caregiver has been involved in the screening and referral process taking place at LGBTQ organizations. This data will be recorded dichotomously (no= 0; yes=1).

The suicide subscale of the behavioral health screen consists of four items asking youth about suicidal ideation and behavior. The response format is dichotomous (yes/no) for each item. The total subscale score uses established clinical cut-offs to indicate those participants who are at risk for suicide.

The gatekeeper behavior scale (GBS) was adapted for the purposes of the study. Preparedness, likelihood, and self-efficacy GBS subscales were examined. These subscales include between 2 and 4 items each. The response format for each item is a likert scale and ranges from 1 (very low) to 5 (very high). The total subscale scores for preparedness, liklihood, and self-efficacy were determined by calculating the mean of all item responses within each subscale. Higher scores on each subscale indicate greater training impact.

The family engagement scale was developed by the investigators and modeled from the items on the gatekeeper behavior scale. The family engagement scale includes two items evaluating: 1) confidence talking with caregivers' about their youth's suicide risk; and 2) knowing how to motivate a caregiver to take their youth to services. The response format is a likert scale and ranges from 1 (strongly disagree) to 6 (strongly agree). The total scale score is determined by calculating the mean of all item responses. Higher scores indicate greater training impact.

Partnership development items were developed by the research team and examined administrator/staff reported confidence in their partnering site's ability to work affirmatively with LGBTQ youth (affirmative item) and help youth with suicidal thoughts and behavior (STB item). They also reported on items assessing liklihood of referring LGBTQ youth to their partnering site (referring item) and reaching out to their partnering site for consultation (consultation item). Partnership development items were completed post-training once administrators/staff were introduced and initiated their cross-site working relationship. The items have a 5-point Likert response scale (1 = very low confidence/liklihood, 5 = very high confidence/liklihood). Higher scores on each item indicate a stronger partnership on the areas assessed.

The Software Usability Measurement Interview (SUMI) will be used to measure usability of the BH-Works program portal for administrators/staff, once software use is initiated following training. The SUMI has 50 Likert scale items (i.e., attitude statements requiring participants to respond with "agree," "undecided" and "disagree") and addresses a standard set of usability factors consisting of: Affect, Control, Helpfulness, Learnability, and Efficiency. The quantitative goal is for each factor to achieve a score of at least 80% of the maximum possible score. Progress over the course of the study period will be tracked. The SUMI is scored and interpreted with reference to a standardization database representing mixed software products. This database is updated yearly. The global usability score is set to an average score of 50 with scores above 50 indicating more user-friendly and below as less user-friendly.

The Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) is a self report measure used to examine clinical preparedness, attitudes, and knowledge with regard to treating LGBT patients. In this study, the total scale score (mean of all individual items) was used. Scores range from 1-7, where higher values represent greater levels of preparedness for working with LGBT patients.

The Acceptability of Intervention Measure (AIM), Feasibility of Intervention Measure (FIM), and Intervention Appropriateness Measure (IAM) examine intervention or program acceptability, feasibility, and appropriateness. Administrators and staff completed these measure at the post-training timepoint, after they had learned about the SGM BH-Works program. Each measure includes 4-items and has a 5-point Likert response scale (1 = completely disagree, 5 = completely agree) for each item. To calculate the total scale score for each measure, responses from the 4-items are averaged for a total score of 1-5. Higher scores indicate greater program acceptability, feasibility, or appropriateness.