LGBTQ+ individuals experience stigma due to their sexual orientation and/or gender identity which has clear, profound, far-ranging effects on LGBTQ+ health including greater risk of suicidality, depression, anxiety, substance use, and poor physical health. Several stigma change strategies have been used to attempt to mitigate the profound impact of LGBTQ+ related stigma in marginalized sexual and gender minority communities. Contact-based interventions to address LGBTQ+ related stigma rest on contact theory, which posits that intergroup contact between individuals of an in-group (majority group) and individuals of an out-group (minority or marginalized group) aids in the reduction of negative stereotypes, prejudice, and resulting discrimination. The definition of “contact” has progressed to encompass various forms of exposure including in-vivo interpersonal contact, vicarious contact, electronic or e-contact and imagined contact. Guided by the Cochrane Handbook for Systematic Reviews of Interventions, we summarize the literature between 2001 and 2020, examining and synthesizing 20 studies that explore contact-based interventions to reduce LGBTQ+ related stigma, stereotyping, prejudice, and discrimination. Overall, several forms of contact-based interventions have demonstrated positive effects on reducing LGBTQ+ related stigma. Future research should include examining the use of contact-based interventions in reducing the stigma faced by individuals within LGBTQ+ communities with intersecting marginalized identities.

The authors use the gateway provider model to examine how parents'/guardians' willingness to seek mental health care for their children is impacted by experiences of affiliate stigma and label avoidance. Although efforts to understand and reduce the detrimental influence of stigma on mental illness are growing, research on possible facilitators to combat stigma and promote treatment seeking is sorely lacking. To address this gap, a cross-sectional survey (N = 89) of young adults aged 18-30, who had been diagnosed with mental illness in childhood, examines the ways in which affiliate stigma, label avoidance, mental health literacy (MHL), and family empowerment (FE) interact to predict parents'/guardians' willingness to seek mental health care for their children. Moderation hypotheses are tested using Hayes' process macro to perform multiple regression analyses involving a two-way interaction among continuous variables. As predicted, the relationship between label avoidance and care seeking is negative and significant at average and high levels of affiliate stigma. Conversely, the relationship between family empowerment and care seeking is positive and significant at low and average levels of MHL. MHL and FE act as the facilitators to care seeking; the relationship between label avoidance and care seeking is negative and significant at low levels of MHL, and the relationship between affiliate stigma and care seeking is negative and significant at low and average levels of FE. Overall, these results indicate that MHL and FE have the potential to buffer the detrimental effects of stigma on care seeking for children's mental healthcare.

Chatbot use is increasing for mobile health interventions on sensitive and stigmatized topics like mental health because of their anonymity and privacy. This anonymity provides acceptability to sexual and gendered minority youth (ages 16–24) at increased risk of HIV and other STIs with poor mental health due to higher levels of stigma, discrimination, and social isolation. This study evaluates the usability of Tabatha-YYC, a pilot chatbot navigator created to link these youth to mental health resources. Tabatha-YYC was developed using a Youth Advisory Board ( n = 7). The final design underwent user testing ( n = 20) through a think-aloud protocol, semi-structured interview, and a brief survey post-exposure which included the Health Information Technology Usability Evaluation Scale. The chatbot was found to be an acceptable mental health navigator by participants. This study provides important design methodology considerations and key insights into chatbot design preferences of youth at risk of STIs seeking mental health resources.

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