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) currently navigate a sociopolitical landscape marked by an escalation of anti-LGBTQIA+ legislation and discrimination, contributing to significant minority stress and mental health disparities. While the need for specialized affirming care is high, there remains a notable absence of culturally responsive, empirically tested interventions that support the well-being of this vulnerable population. The primary objective was to assess feasibility, acceptability, and 12-month longitudinal outcomes of Tuned In!, an LGBTQIA+ affirmative mindfulness-based intervention (MBI) co-created with SGDY to build resilience and coping mechanisms like self-advocacy and grounding. The authors also sought to explore whether Tuned In! could enhance identity-based protective factors.

Methods: Utilizing a community-based participatory action research (CBPAR) approach, this open pilot feasibility study tested Tuned In! with a diverse sample of 52 SGDY (ages 16–29) recruited in Connecticut through purposive sampling. Data was collected at four time points: baseline, post-intervention, 6-month follow-up, and 12-month follow-up. Standardized measures included the BDI (depression), STAI (anxiety), BSI (distress), CAMM (mindfulness), SCS (self-compassion), and a Sexual Self-Efficacy Scale. To account for the nested structure of the longitudinal data, we employed two-level hierarchical linear modeling (HLM). This approach treated the four waves of repeated observations as Level 1 and individual participants as Level 2, with both intercept and slope treated as random effects to assess the rate of change over time.

Results: Results support the feasibility and acceptability of Tuned In!, with strong retention and sustained participant engagement over time. 52 SGDY participants (ages 16–29) completed the program, with 51 completing the post-test assessment, 48 completing the 6-month follow-up, and 44 completing the 12-month follow-up. Hierarchical Linear Modeling analyses revealed significant, long-term improvements across all measured domains. Participants demonstrated significant and sustained decreases in depression (β = −1.30, SE = 0.32, p < 0.001), anxiety (β = −1.09, SE = 0.25, p < 0.001), and overall psychological distress (β = −0.10, SE = 0.03, p < 0.001) at the 12-month mark. Simultaneously, significant increases were observed in sexual self-efficacy (β = 1.72, SE = 0.60, p = 0.004), mindfulness ((β = 1.59, SE = 0.33, p < 0.001), and self-compassion (β = 0.14, SE = 0.03, p < 0.001). Participant feedback further supported the intervention’s acceptability, with 95% reporting substantial learning and 96% indicating that intervention skills learned were applicable to managing stress and personal challenges across a variety of circumstances.

Conclusions and Implications: The findings indicate that the positive effects of Tuned In! were maintained over a 12-month period, positioning affirmative MBIs as a promising tool for mitigating minority stress. These results underscore the democratic imperative to provide evidence-informed, identity-affirming care that facilitates empowerment among SGDY. Results also highlight the value of CBPAR in developing interventions that promote social justice and address minority stress among SGDY. Research, practice, and policy implications will be explored. In the current sociopolitical climate, these findings emphasize the importance of continued adaptation to advance inclusive social work practice, policy, and research that serves diverse populations.