Project Grant K23MH137389

ALIVE: DEVELOPMENT AND FEASIBILITY OF A PSYCHOSOCIAL INTERVENTION FOR SEXUAL AND GENDER MINORITY AUTISTIC ADULTS - PROJECT SUMMARY THIS IS A K23 AWARD APPLICATION FOR DR. LAURA GRAHAM HOLMES, A CLINICAL PSYCHOLOGIST WITH EXPERTISE IN AUTISM, TO INDEPENDENTLY CONDUCT RESEARCH TO DEVELOP PSYCHOSOCIAL INTERVENTIONS THAT WILL IMPROVE MENTAL HEALTH AND QUALITY OF LIFE FOR AUTISTIC ADULTS. THE K23 WILL PROVIDE HER WITH THE SUPPORT NECESSARY TO ACQUIRE CRITICAL SKILLS IN THREE KEY CAREER DEVELOPMENT AREAS: 1) COMMUNITY-ENGAGED INTERVENTION DEVELOPMENT; 2) CLINICAL TRIAL DESIGN AND EVALUATION OF IMPLEMENTATION; 3) DEVELOPING ETHICAL DATA AND SAFETY MONITORING PROTOCOLS FOR POPULATIONS AT HEIGHTENED RISK FOR SUICIDE. TO ACHIEVE HER GOALS, DR. GRAHAM HOLMES HAS ASSEMBLED AN INTERDISCIPLINARY MENTORING TEAM COMPRISED OF DR. SUSAN WHITE (CO-PRIMARY MENTOR), A RECOGNIZED LEADER IN PSYCHOSOCIAL INTERVENTION DEVELOPMENT IN AUTISM, DR. SARIT GOLUB (CO-PRIMARY MENTOR), A LEADING EXPERT IN CLINICAL TRIALS AND IMPLEMENTATION RESEARCH WITH SEXUAL AND GENDER MINORITY POPULATIONS, AND DR. CARLA MAZEFSKY (CO-MENTOR), A PIONEER IN RESEARCH ON EMOTION DYSREGULATION AND SUICIDE IN AUTISM. COMPLEMENTING THESE EXPERTS, DR. GRAHAM HOLMES ALSO HAS A 5 MEMBER ADVISORY COMMITTEE TO SUPPORT HER PROPOSED DEVELOPMENT OF A PSYCHOSOCIAL INTERVENTION FOR SEXUAL AND GENDER MINORITY AUTISTIC ADULTS. A SUBSTANTIAL PROPORTION OF AUTISTIC PEOPLE IDENTIFY AS SEXUAL OR GENDER MINORITIES (E.G., LESBIAN, GAY, BISEXUAL, TRANSGENDER OR GENDER NON-CONFORMING). CURRENT EVIDENCE DEMONSTRATES THAT AUTISTIC SEXUAL AND GENDER MINORITY PEOPLE ARE AT INCREASED RISK FOR CO-OCCURRING MENTAL HEALTH CONDITIONS INCLUDING DEPRESSION, ANXIETY, AND SUICIDE ATTEMPTS COMPARED TO AUTISTIC CISGENDER HETEROSEXUAL ADULTS AND REPORT MORE UNMET MENTAL HEALTH CARE NEEDS. DR. GRAHAM HOLMES' OBJECTIVE IS TO ADDRESS THE LACK OF AVAILABLE EVIDENCE-BASED PSYCHOSOCIAL INTERVENTIONS FOR THIS POPULATION. HER RESEARCH WILL RESULT IN PRELIMINARY DATA TO SUPPORT A CLINICAL TRIAL TO TEST A NOVEL COMMUNITY- BASED MINORITY STRESS INTERVENTION FOR SEXUAL AND GENDER MINORITY AUTISTIC PEOPLE. THE INTERVENTION WILL ADAPT EVIDENCE-BASED PRINCIPLES FOR ADDRESSING MINORITY STRESS AMONG SEXUAL AND GENDER MINORITIES USING A CO- DESIGNED, CO-FACILITATED, ONLINE GROUP PSYCHOEDUCATION INTERVENTION APPROACH. SHE PROPOSES THE FOLLOWING SPECIFIC AIMS: AIM 1: GATHER FORMATIVE QUALITATIVE DATA FROM AUTISTIC SEXUAL AND GENDER MINORITY PEOPLE AND PROFESSIONALS WITH RELEVANT EXPERIENCE TO INFORM THE DEVELOPMENT OF THE AUTISTIC LGBTQIA+ AFFIRMING INTERVENTION (ALIVE); AIM 2: PILOT TEST AND REFINE THE INTERVENTION CONTENT, DELIVERY, AND EFFICACY AND IMPLEMENTATION MEASURES VIA A RANDOMIZED CONTROLLED TRIAL IN PREPARATION FOR A HYBRID TYPE 1 (EFFICACY + IMPLEMENTATION) CLINICAL TRIAL. THE PROPOSED RESEARCH IS SIGNIFICANT BECAUSE IT WILL RESULT IN AN ACCESSIBLE, SCALABLE INTERVENTION FOR A VULNERABLE, UNDERSERVED POPULATION. THE PROPOSED RESEARCH IS INNOVATIVE BECAUSE IT USES AN EVIDENCE-BASED APPROACH DESIGNED TO ADDRESS MINORITY STRESS THAT WILL BE ADAPTED VIA A COMMUNITY-ENGAGED PROCESS FOR A POPULATION WITH MULTIPLE INTERSECTING MINORITY IDENTITIES.