State laws addressing teen dating violence in US high schools: A difference-in-differences study.

OBJECTIVE: Teen dating violence (TDV) is prevalent with lifelong adverse consequences, and strategies to reduce its burden are needed. Many U.S. states have enacted laws to address TDV in schools, but few studies have examined their effectiveness. This study aimed to assess whether state TDV laws were associated with changes in physical TDV victimization among high school students. METHODS: We used repeated cross-sectional data of high school students from the Youth Risk Behavior Survey across 41 states from 1999 to 2019. Using a difference-in-differences approach with an event study design, we compared changes in past-year physical TDV in states that enacted TDV laws (n = 21) compared to states with no required laws (n = 20). Analyses accounted for clustering at the state-level and state and year-fixed effects. We conducted sensitivity analyses to assess the robustness of our findings. RESULTS: In our sample of 1,240,211 students, the prevalence of past-year physical TDV was 9.2% across all state-years. In 1999, the prevalence of TDV at the state-level ranged from 7.5 to 13.0%; in 2019, the prevalence ranged from 3.7 to 10.5%. There was no significant association between TDV laws and past-year physical TDV. Six or more waves after enactment, we observed a non-significant 1.7% percentage point reduction in TDV in states with TDV laws (95% CI: -3.6 to 0.3 percentage points; p = 0.10). CONCLUSIONS: We found no significant association between enactment of TDV laws and physical TDV among high school students. Further research is needed to understand how TDV laws are implemented and components of TDV laws that may influence effectiveness.

High School Follow-Up of the Dating Matters® RCT: Effects on Teen Dating Violence and Relationship Behaviors.

Teen dating violence (TDV) is a significant public health problem that can have lifelong consequences. Using a longitudinal, cluster randomized controlled trial (RCT), this study examines whether the Dating Matters comprehensive prevention model, implemented in middle school, prevented TDV and negative relationship behaviors and promoted positive relationship behaviors in high school (9th-11th grades), when compared with a standard of care intervention. Dating Matters includes programs for sixth to eighth grade youth and their parents, training for school staff, a youth communications program, and policy and data activities implemented in the community. Self-report survey data were collected from students in 46 middle schools that were randomly assigned to condition within site. Students completed two surveys (fall and spring) in each middle school grade and a single survey in the spring of each high school grade. This study examined self-reported TDV perpetration and victimization, use of negative conflict resolution strategies, and positive relationship skills in the high school follow-up. While varying patterns emerged, latent panel models demonstrated significant program effects for all outcomes. Dating Matters students reported 19% reduced risk for TDV perpetration, 24% reduced risk for TDV victimization, 7% reduced risk for use of negative conflict strategies, and 3% more use of positive relationship skills, on average across time and cohort, than standard of care students. On average, Dating Matters, implemented in middle school, continued to be more effective at reducing TDV perpetration, TDV victimization, and use of negative conflict resolution strategies in high school than an evidence-based comparison program.Trial Registration: clinicaltrials.gov Identifier: NCT01672541.

Self-Efficacy to Refuse Sex Mediates the Relationship Between Dating Violence Victimization and Sexual Risk Behavior.

PURPOSE: While cross-sectional studies have shown that teen dating violence (TDV) victimization is linked to sexual risk behavior (SRB), the pathway between these variables is not well-understood. To address this knowledge gap, we explore the mediating role of self-efficacy to refuse sex in the longitudinal relationship between physical TDV victimization and subsequent SRB among adolescents. METHODS: Self-report data from three prior longitudinal studies were harmonized to create a single aggregated sample of primarily racial and ethnic minority adolescents (N = 4,620; 51.4% Hispanic, 38.5% Black, and 58% female) from 44 schools in the southwest U.S. Participants' physical TDV victimization at baseline (seventh and eighth grade), self-efficacy to refuse sex at 12-month follow-up, and SRB at 24-month follow-up was tested using mediation models with bias corrected bootstrapped confidence intervals. All regression models controlled for age, race, parental education, SRB at baseline, and intervention status. RESULTS: Physical TDV victimization at baseline was associated with refusal self-efficacy at 12 months and SRB (e.g., frequency of vaginal and oral sex, lifetime number of vaginal sex partners, and number of vaginal sex partners in the past three months without condom use) at 24 months. Refusal self-efficacy mediated the link between physical TDV victimization and increased risk of SRB for females and males, to a lesser extent. DISCUSSION: Adolescent victims of physical TDV report diminished self-efficacy to refuse sex, predisposing them to engage in SRBs, including condomless sex.

Economic Abuse and Help-Seeking Intentions Among Adolescents.

Economic adolescent relationship abuse (ARA) includes coercive behaviors leading to interference with education, employment, and finances. To date, no study has examined help seeking among adolescents and young adults if they were to experience economic ARA. The goals of this article include examining: (a) help-seeking intentions of adolescents regarding economic ARA; (b) help-seeking sources and reasons for not seeking help; and (c) differences in help-seeking intentions based on age, race/ethnicity, gender identity, and experiences of economic ARA. We conducted a cross-sectional survey of adolescents ages 13-19 focused on economic ARA experiences and help seeking. We performed descriptive statistics of help-seeking intentions, sources, and barriers. We utilized logistic regression, adjusted for age, race/ethnicity, and gender identity, to explore associations between economic ARA victimization and help-seeking intentions. Of 2,852 participants, 56% said they would seek help for economic ARA. Adolescents with positive help-seeking intentions shared that they would seek help from their parents (43%) or friends (35%). Those less likely to seek help were concerned about others finding out (32%), not being believed (31%), or authority figures being notified (31%). Help-seeking intentions were lower among Black/African American adolescents (aOR = 0.55, CI [0.43, 0.70]) and Multiracial adolescents (aOR = 0.26, CI [0.16, 0.42]) compared to White adolescents. Help-seeking intentions were higher among gender diverse adolescents (aOR = 5.78, CI [2.98, 11.22]) and those ages 15-17 years (aOR = 1.84, CI [1.36, 2.47]) compared to those identifying as female and ages 18-19 years. Help-seeking intentions were lower among adolescents who experienced economic ARA (aOR = 0.61, CI [0.51, 0.72]). While the majority of adolescents reported that they would seek help if they experienced economic ARA, those who had experienced economic ARA were less likely to report intentions to seek help. Supportive interventions for adolescents experiencing economic ARA are needed.

Costs of Implementing Teen Dating Violence and Youth Violence Prevention Strategies: Evidence From 5 CDC-Funded Local Health Departments.

OBJECTIVES: In 2016, the Centers for Disease Control and Prevention supported 5 local health departments (LHDs) to implement teen dating violence and youth violence primary prevention strategies across multiple levels of the social-ecological model and build capacity for the expansion of such prevention efforts at the local level. The objective of this study was to estimate the total cost of implementing primary prevention strategies for all LHDs across 3 years of program implementation. METHODS: We used a microcosting analytic approach to identify resources and compute costs for all prevention strategies implemented by LHDs. We computed the total program cost, total and average cost per strategy by social-ecological model level, and average cost of implementation per participant served by the program. All costs were inflated via the monthly Consumer Price Index and reported in August 2020 dollars. RESULTS: For 3 years of program implementation, the total estimated cost of implementing teen dating violence and youth violence primary prevention strategies was >$7.1 million across all 5 LHDs. The largest shares of program-related costs were program staff (55.9%-57.0%) and contracts (22.4%-25.5%). Among prevention strategies, the largest share of total costs was for strategies implemented at the community level of the social-ecological model (42.8%). CONCLUSIONS: The findings from this analysis provide a first look at the total costs of implementing comprehensive teen dating violence and youth violence primary prevention strategies and serve as a foundation for investments in local violence prevention funding for young people.

The Health Care Provider's Role in Addressing Adolescent Relationship Abuse.

Adolescent relationship abuse (ARA) is highly prevalent across all sociodemographic groups with negative outcomes in multiple domains of health. Using a healing-centered engagement approach, health care providers can support healthy adolescent relationships and connect ARA survivors to resources and supports to ensure health and well-being. Essential components of health care support for adolescents experiencing ARA include validation of disclosure, assessing safety, a warm hand-off to advocacy resources, addressing immediate and long-term health needs, and connection to a trusted adult. Informing adolescents about limits of confidentiality and use of shared decision-making after ARA disclosure recognizes adolescents' lived experiences and emerging autonomy.

Cumulative Incidence of Physical and Sexual Dating Violence: Insights From A Long-term Longitudinal Study.

Decades of inquiry on intimate partner violence show consistent results: violence is woefully common and psychologically and economically costly. Policy to prevent and effectively intervene upon such violence hinges upon comprehensive understanding of this phenomenon at a population level. The current study prospectively estimates the cumulative incidence of sexual and physical dating violence (DV) victimization/perpetration over a 12-year timeframe (2010-2021) using diverse participants assessed annually from age 15 to 26. Data are from Waves 1-13 of an ongoing longitudinal study. Since 2010 (except for 2018 and 2019), participants were assessed on past-year physical and sexual DV victimization and perpetration. Participants (n = 1,042; 56% female; Mage baseline = 15) were originally recruited from seven public high schools in southeast Texas. The sample consisted of Black/African American (30%), White (31%), Hispanic (31%), and Mixed/Other (8%) participants. Across 12 years of data collection, 27.3% experienced sexual DV victimization and 46.1% had experienced physical DV victimization by age 26. Further, 14.8% had perpetrated at least one act of sexual DV and 39.0% had perpetrated at least one act of physical DV against a partner by this age. A 12-year cumulative assessment of physical and sexual DV rendered prevalence estimates of both victimization and perpetration that exceeded commonly and consistently reported rates in the field, especially on studies that relied on lifetime or one-time specified retrospective reporting periods. These data suggest community youth are at continued and sustained risk for DV onset across the transition into emerging adulthood, necessitating early adolescent prevention and intervention efforts that endure through late adolescence, emerging adulthood, and beyond. From a research perspective, our findings point to the need for assessing DV on a repeated basis over multiple timepoints to better guage the full extent of this continued public health crisis.

Teen perceptions of adolescent dating violence.

INTRODUCTION: Previous research shows that adolescents who experience dating violence most often disclose their victimization to a peer or friend, more so than to other sources of support. However, surprisingly little research has explored how adolescents respond to peer disclosures of dating violence. Addressing this gap, the present study assessed variations in adolescents' perceptions of blame, interpretations of the incident as violence, and intentions to respond across physical, psychological, sexual, cyber-psychological, and cyber-sexual dating violence scenarios. METHODS: As part of a national research project across Canada, 663 high school adolescents (432 girls, 65.2%) between the ages of 14-17 were randomly assigned to complete a questionnaire which included one of five different hypothetical dating violence scenarios. Next, participants responded to questions about their perceptions of the incident, as well as victim and perpetrator blame and responsibility, and their intentions to respond. RESULTS: Results indicated that the type of dating violence experienced and the age and gender of participants all played a role in perceptions of blame, understandings of violence, and intentions to respond. CONCLUSIONS: As one of the first studies to explore how adolescents perceived and responded to dating violence, considering both in-person and cyber forms of dating violence, this study fills an important gap in the literature. Findings underscore the uniqueness of cyber forms of dating violence and how pre/intervention programs must address the specific contexts and issues unique to each type of dating violence.

Victimization Perceived and Experienced by Teens in an Abusive Dating Relationship: The Need to Tear down Social Myths.

The phenomenon of adolescent dating violence is a social health problem that affects thousands of people in different contexts and parts of the world. To date, much of the work that has focused on analysing this phenomenon has tended to study it from the perspective of victimized adolescent girls, considering that gender violence predominates in violent pair relationships. Nonetheless, there is a growing body of evidence that the victimization of adolescent boys is a reality. Thus, mutual violence between boys and girls is increasingly prevalent. Given this context, the present study's objective was to analyse and compare the victimization profile of a sample of female and male adolescents, taking into account the variables most commonly associated with victimization in these abusive relationships (perceived violence suffered, perceived severity, sexism, and moral disengagement). With this objective, different instruments were administered (CUVINO, Scale of Detection of Sexism Adolescents (DSA), and Mechanism of Moral Disengagement Scale (MMDS)). Data analysis based on the construction of a multiple linear regression model confirmed that the boys and girls in the sample revealed having suffered violence from their partners to a different degree. It is evident that the victimization profile of the two sexes is different. Thus, boys show less perception of severity, more sexism, and greater use of certain moral disengagement mechanisms than girls. These results reveal the need to tear down social myths and construct prevention programs that take into account different victimization profiles.

Is Trauma Exposure More Harmful for Sexual Minority Youth? Differences in Trauma-Suicide Associations in a Nationally Representative Sample of U.S. Youth and Implications for Suicide Prevention.

Purpose: Lesbian, gay, and bisexual (LGB) youth experience disproportionately high rates of suicidality and exposure to traumatic events, such as sexual violence and teen dating violence. Rates of suicidality and exposure to traumatic events also vary by sexual minority subgroup. The purpose of this study was to: (1) explore the impact of LGB identity on the relationship between violence exposure and suicide; and (2) to examine variations by sexual identity. Method: A subsample of respondents who reported on their sexual identity in the Youth Risk Behavior Survey (n = 14,690) was used to examine if the associations between sexual and dating violence with suicide outcomes (suicidal ideation, planning, and suicide attempt) depended on the sexual identity of the respondent. Logistic regression models were fitted with an interaction effect to quantify heterogeneity of associations across identity strata. Results: Overall interaction tests mostly indicated heterogeneity of associations between sexual violence and physical dating violence. Several contrast of strata associations suggested substantive probability differences between sexual minority respondents and their heterosexual peers. Conclusion: While exposure to violence was broadly associated with increased probability of experiencing any type of suicidality, LGB and questioning youth were significantly more likely to experience suicidality compared to their heterosexual peers. Gay and lesbian youth demonstrated the strongest probability of experiencing suicidal thoughts and behaviors among survivors of sexual violence, while bisexual youth may be more at risk following dating violence. Implications for future research and suicide prevention are discussed.

Intimate Partner Violence and Sexual Violence.

Intimate partner violence and sexual violence represent significant public health challenges that carry many individual and societal costs. More than 1 in 3 women (35.6%) and more than 1 in 4 men (28.5%) in the United States have experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime. Clinicians play an integral role on the screening, identification, and management of these sensitive issues.

Can Attitudes Serve as Proxies for Behavioral Outcomes of Dating Violence Prevention Programs? Broader Lessons From a Pilot Evaluation of the Relationship Education Project.

Teen dating violence (TDV) is a prevalent problem in the United States. Although research indicates that prevention programs have favorable effects on TDV knowledge/attitudes, there is limited evidence of meaningful effects on behavior. This is important, as researchers often measure the former as a proxy for the latter. The present study uses pre-posttest data from students participating in the Relationship Education Project, a TDV prevention program implemented in 19 middle and high schools in South Carolina, to examine associations between changes in TDV attitudes and TDV behavior. Findings indicate favorable changes in attitudes toward controlling and supportive dating behaviors were associated with lower incidents of some TDV behaviors. Implications for measuring TDV program effects and preventing TDV by fostering attitude change are discussed.

Physical Dating Violence Victimization among LGBTQ Youth: Disclosure and Association with Mental Health.

Youth dating violence and youth suicide are both major public health concerns. However, little research examines the intersection of these issues among lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth. The current study examined the association between physical dating violence victimization and mental health using online survey data collected from 39,126 LGBTQ youth of ages 13 to 24 in the United States. Overall, 11% of LGBTQ youth who were in a relationship in the past year experienced physical dating violence victimization, with 4% having experienced it once and 7% having experienced it multiple times. Rates of experiencing physical dating violence victimization varied based on a number of youth characteristics and environmental factors. Past-year physical dating violence victimization was associated with nearly four times the odds of attempting suicide in the past year. Given the intersection of suicide risk and dating violence among LGBTQ youth, dating violence prevention organizations must be LGBTQ-inclusive, and suicide prevention must be equipped to address dating violence victimization. The higher rates of physical dating violence victimization among multiple marginalized and socioeconomically disadvantaged LGBTQ youth suggest the need for an intersectional approach that addresses the structural factors that place LGBTQ youth at risk for physical dating violence.

Looking Within: An Analysis of Intimate Partner Violence Victimization Among Sexual Minority Youth.

Sexual minority youth are at increased risk of intimate partner violence (IPV) victimization compared to their heterosexual peers. However, the sexual minority population is not a homogenous group and risk of IPV victimization varies by LGB+ subgroup (e.g., gay/lesbian, bisexual, and unsure). Using two waves of data (2017, 2019) from the National Youth Risk Behavior Survey (YRBS), this study analyzes (a) differences in physical and sexual IPV victimization between heterosexual and sexual minority youth, (b) within group differences among sexual minority youth, and (c) if the relationship between IPV victimization and sexual identity is attenuated after controlling for sociodemographic characteristics and theoretically relevant risk factors. Results indicate that sexual minority youth are at elevated risk of IPV victimization compared to their heterosexual peers. Within-LGB+ analyses show that bisexual youth are more likely than gay/lesbian youth to be victims of sexual IPV. The association between physical and sexual IPV victimization and sexual identity is partially attenuated by sociodemographic variables and observed risk factors. Findings indicate that intervention and prevention programming should be tailored to identify, and treat, the risks and needs of unique, at-risk populations.

Adapting Adolescent Dating Violence Prevention Interventions to Victims of Child Sexual Abuse.

Considering the increased risk of revictimization, adolescents who have experienced child sexual abuse (CSA) are a priority subpopulation for the prevention of dating violence. Yet, intervention programs often focus on psychological symptomology associated with CSA; few tackle issues specific to relational violence. Addressing the relational traumatization of adolescents with a history of CSA is essential to prevent their revictimization. Given specific CSA sequelae related to intimacy and engagement in sexual behaviors, there is a need for tailoring interventions to boy and girl survivors. A case study of a group intervention designed for adolescent girls with a history of CSA was conducted. The context adaptation, based on intervention mapping proposed by Bartholomew and colleagues, served as a theoretical framework. Four steps were taken to ensure that the intervention addressed CSA youth needs: (a) needs assessment, (b) analysis of the conceptual framework of the original program, (c) selection of interventions and developing new interventions, and (d) validation with a committee of practitioners. This approach provided an understanding of risk factors and intervention priorities using the problem logic model. The original program was enhanced by adding four interventions addressing the prevention of dating violence. These interventions were then validated by practitioners before implementation in the setting. The approach underscores the relevance of understanding the needs of the clientele and of adopting a collaborative approach to ensure the proposed interventions are relevant.

Centering Media Literacy and Cultural Tailoring: A Scoping Review of Interventions Used to Address Black Adolescent Intimate Partner Violence.

Intimate partner violence (IPV) among Black adolescents is a critical public health issue, as they report higher levels of IPV perpetration and victimization than their counterparts from other racial groups. Although practitioners frequently implement educational programs to reduce and prevent adolescent relationship violence among adolescents, the extent to which these interventions have been culturally tailored to Black youth is unclear. The purpose of this scoping review is to investigate the nature and effects of cultural tailoring in IPV interventions delivered to Black adolescent populations as well as any critical media literacy (CML) content therein. We conducted searches of three databases for peer-reviewed research published in the United States between 2000 and 2020 that evaluated an IPV-focused educational intervention with a predominantly Black adolescent sample. A total of eight original studies met our inclusion criteria. Findings showed that five of the articles mentioned some level of cultural tailoring for the participants. However, the level and nature of that tailoring ranged widely with regard to curriculum development, staffing, and other program elements. No studies included any elements of CML education. Overall results indicate positive effects of IPV interventions on adolescents and reduced acceptance of violence in romantic relationships. This scoping review highlights a lack of clarity on methods used for cultural tailoring of curriculum based IPV interventions, vague application of social learning theoretical frameworks, and the potential benefits of CML content.

What Is Not in the Methods Section: Challenges, Successes, and Lessons Learned From Conducting School-Based Interpersonal Violence Prevention Research.

Interpersonal violence (IV)-which includes sexual assault, sexual harassment, teen dating violence, bullying, and other forms of violence-among youth (i.e., individuals 18 years of age or younger) is a public health crisis in the United States. As such, preventing IV among youth is a public health priority. Schools are natural settings for IV prevention among youth. However, conducting school-based IV prevention research with youth in school settings is riddled with challenges, and there is little systematic discussion of lessons learned from doing this work. As such, the purpose of this paper is to outline challenges, successes, and lessons learned from conducting school-based IV prevention research, as ascertained by four researchers with over 75 years of collective experience conducting school-based IV prevention research. Specifically, we focus on the importance of researchers (1) doing research on the school/school district prior to reaching out about potential partnerships; (2) establishing relationships with school partners that are characterized by being present, trustworthiness, and respect as well as the prioritization of school partners' ideas over one's research agenda; (3) working collaboratively with school partners to conceptualize and fund school-driven ideas; (4) preparing for pushback, often from parents/caregivers; and (5) embracing reciprocity (i.e., do things to support your school partners that may not directly benefit you). Additional considerations for recruitment, enrollment, and retention; program implementation and data collection; and dissemination are discussed.

Domestic Violence Protection Orders for Teen Dating Violence: An Analysis of State Laws and Practices.

PURPOSE: The purpose of this research is to provide an overview of state laws on domestic violence protection orders (DVPO) for teen dating violence. DVPOs are one legal remedy that is available to victims of intimate partner violence to reduce the potential risk of future violence. However, minors are often prohibited from filing a DVPO on their own due to statutory requirements. METHOD: Using multiple resources and a Westlaw search, we developed a list of state laws pertaining to the statutory requirements for DVPOs for partner-abused minors. We detailed the content of each state's laws and specific requirements, including self-petitioning, eligible age, dating relationship, and stalking. Additionally, we explored how statutes were interpreted by judicial and non-judicial branches of the governments and nonprofit victim service organizations, and searched other statutory provisions for states where the state statute on the DVPO eligibility for teen dating violence was unclear. FINDINGS: Our findings indicate that state statutes vary in terms of whether minors can be granted DVPOs, whether they can self-petition without a guardian, whether a non-sexual romantic relationship is covered, and whether stalking is covered. Additionally, a variety of courts' practices and governmental opinions pertaining to protection remedies for child abuse, sexual violence, harassment, or stalking and other statutory provisions other than DVPOs was found. DISCUSSION: This research discusses the importance of more inclusive statutory revisions in each state, and the need to secure greater information accessibility to eligibility requirements, instructions, and procedures for obtaining a DVPO for minors.

Profiles and Risk Factors for Teen Dating Violence in Spain.

Teen dating violence (TDV) refers to a wide range of partner-directed harmful behaviors among adolescents. Since it was first documented in the 1980s, there is a growing interest in TDV due to its potentially devastating mid- and long-term consequences. Aiming at the early detection of TDV onset with prevention purposes, research has focused on the detection of typologies of perpetrators and/or victims as well as on identifying risk and protective factors for its occurrence. Research with Spanish adolescents, however, is very limited. To fill this gap, we recruited a total of 2,319 adolescents from different regions in Spain, out of which, 1,079 reported having had a romantic partner during the last year. These filled out measures of TDV (perpetration and victimization), school aggression, hostile and benevolent sexism, empathy, assertiveness, psychological inflexibility (general measures), and psychological inflexibility with prejudice thoughts. A cluster analysis revealed that adolescents could be divided into two clusters as a function of their TDV profile: Cluster 1, including close to 76% of the sample (boys and girls), presented low TDV perpetration and victimization; Cluster 2, including 24% of the sample (boys and girls), presented higher TDV perpetration and victimization. Regression analyses revealed that, as compared to those in Cluster 1, adolescents in Cluster 2 were more likely to be older boys who scored high in benevolent sexism, overt and relational school aggression, and personal distress, and low in behavior regulation skills, perspective taking, and practical personal ability. We discuss the implications of these findings for the design of evidence-based TDV prevention campaigns.

LGBTQ+ Youth-Generated Intervention Concepts for Reducing Teen Dating Violence Inequities.

Lesbian, gay, bisexual, transgender, queer, nonbinary, and other sexual and gender minority (LGBTQ+) youth are at substantially greater risk than cisgender heterosexual youth for experiencing teen dating violence (TDV) victimization, including emotional, physical, and sexual abuse within dating/romantic relationships. Despite these inequities, there are no evidence-based interventions designed specifically to address TDV among LGBTQ+ youth. To redress this dearth of interventions, we utilized a youth-centric approach, wherein 46 LGBTQ+ youth co-developed intervention concepts for reducing TDV. Participants engaged in a process of generating, prioritizing, and refining intervention concepts for reducing TDV inequities using human-centered design activities. LGBTQ+ youth generated eight intervention concepts, including the name, description, audience, problem focus, goals, and process for each. Their interventions focused on strategies for enhancing education, support systems, and advocacy. The intervention concepts had a wide variety of intended audiences, including LGBTQ+ and non-LGBTQ+ youth, teachers, school administrators, and policymakers. Overall, LGBTQ+ youth sought to improve education and skills pertaining to violence, sexual health, and healthy relationships; enhance support systems and resources for students' basic, mental health, and safety needs; and build advocacy channels related to "outing" and LGBTQ+ students' needs. These LGBTQ+ youth-generated programmatic and policy intervention concepts, in addition to our human-centered design approach, can be directly leveraged by health promotion practitioners and prevention experts into future intervention development, implementation, and evaluation efforts to improve LGBTQ+ youth health, well-being, resilience, and advocacy.