3 - (OP4) Web-based Screening and Brief Intervention Tool for Alcohol Use Following Sexual Assault: Adaptation for Sexual Minority Women and Gender Diverse Adults

Sexual minority women (SMW) and transgender and gender diverse (TGD) people are at elevated risk for alcohol use disorder compared to their heterosexual cisgender counterparts. SMW and TGD people also experience higher rates of sexual assault compared to heterosexual cisgender people. Elevated risk of sexual assault may explain increased alcohol use among SMW and TGD people. Further, a unique risk factor for alcohol use in this population is the experience of chronic minority stress (e.g., discrimination, stigma) due to stigmatization of sexual and gender minority identities in society. Few survivors of sexual assault seek services for substance use. SMW and TGD survivors face additional barriers to care, such as limited affirmative services, stigma, and discrimination. Yet, there is a dearth of available alcohol use interventions focused specifically on the needs and experiences of SMW and TGD people. The current project adapted a web-based screening and brief (SBI) tool for alcohol misuse for SMW and TGD survivors of adult sexual assault. The SBI consists of psychoeducation, assessment, personalized feedback, and brief intervention based on motivational interviewing. We culturally tailored the SBIT intervention by integrating personalized normative feedback specific to SMW and TGD norms and inclusion of sexual and gender minority stress content. We evaluated the usability and acceptability of the adapted intervention via qualitative interviews and surveys among 26 SMW and TGD survivors (Mage=28.9, range 20-56; 50% non-Hispanic White, 15.4% Hispanic/Latine, 11.5% Asian, 11.5% Black/African American, 11.5% Biracial/Multiracial). Overall, participants rated the intervention highly on a Likert-type scale from 1 (strongly disagree) to 5 (strongly agree) agreeing that the SBIT: is helpful (M=4.58, SD=.58), includes beneficial information for LGBTQ+ people (M=4.54, SD=.58), using it would improve their alcohol use (M=4.00, SD=0.69), and they would recommend the tool to LGBTQ+ friends (M=4.42, SD=.76). Iterative revisions were made to the adapted web-based SBI tool based on feedback from qualitative interviews in consultation with the study team throughout data collection. Interview transcripts and notes were reviewed again after conclusion of data collection and additional revisions were made according to participant feedback on usability, visual design, and content. We highlight individual participant feedback from interviews and revision made to the SBI tool (e.g., change of color scheme, removal of personalized normative feedback, revision of recommended drinking limits to remove “sex assigned at birth” language). There are no interventions for alcohol use and sexual assault-related distress that are culturally tailored for SMW and TGD survivors, despite elevated rates of alcohol use, sexual assault, and unique identity-based stress in this population. Web-based SBI is a cost-effective and scalable model of service delivery and the adapted SBI for SMW and TGD adults has the potential to address a significant gap in research and service provision. Implications for future brief interventions aimed at reducing alcohol use disparities among SMW and TGD survivors of sexual assault will be discussed.