(PS9-1) A Mixed Methods Analysis of a Community-based Implementation Pilot Study: A DBT Skills Group Delivered in a Black Transgender Woman-led Community Organization

Background. People with multiply marginalized identities, such as Black transgender women (TW), face high rates of discrimination, violence, and associated mental health disparities (James et al., 2016; McGauchy, 2019). This discrimination permeates into the healthcare system, resulting in an absence of safe and affordable formal support services (e.g., Jaffee et al., 2016; James et al., 2016; Socías et al., 2014). Community engaged dissemination and implementation science (CEDI; Holdt & Chamber, 2017) is a process of collaborating with community members to implement evidence-based interventions within community spaces to create a system of care that is accessible, sustainable, and effective for the targeted community. However, CEDI in TW community is sparse. Additionally, current measures to assess implementation outcomes have not been deemed reliable or valid within this population. Purpose. This project is a CEDI study of a dialectical behavior therapy (DBT) skills group delivered within a Black, TW-led community-based organization (CBO) to address mental distress identified by community constituents while harnessing community strength and resilience. This study reports on mixed methods findings to gain a deeper understanding of individual outcomes. Methods. In order to not deny treatment to community members, all constituents of the CBO (approximately 82% of whom identify as Black or Brown TW) were eligible to participate. DBT groups were delivered over three, independent, 12-session series to allow for iterative refinement between series. Prior to program start, participants completed surveys assessing mindfulness (FFMQ-SF; Bohlmeijer et al., 2011); interpersonal empowerment (Bolton & Brookings, 1998); depression, anxiety, and stress (DASS-21; Lovibond & Lovibond, 1995); and difficulties with emotional regulation (DERS-16; Bjureberg et al., 2016). After program completion, participants completed exit interviews assessing their subjective experience in the group as well as identical post-intervention surveys plus group dynamic (GTES; Hunter et al., 1996) and therapeutic rapport (WAI-SR; Hatcher & Gillaspy, 2006) questionnaires. Interviews were analyzed using RAPID analysis (Hamilton, 2013). Surveys will be analyzed using descriptive statistics and repeated measures ANOVA. Domains identified during the RAPID analysis will serve as the primary organizing structure for a mixed methods joint display. This display will integrate relevant quantitative and qualitative data within identified domains to draw conclusions that are grounded in the combined strengths of both types of data. Results. N=15 participants have enrolled in the study to date with a goal of N=30 by series end. Data collection is ongoing with analysis completion planned for Summer 2024. Current joint display domains include Managing Depression, Emotion Regulation, Mindfulness Skills, Self-Worth, Group Dynamics, and Therapeutic Alliance. Discussion. Findings will be discussed in terms of the preliminary impact of the DBT skills group on community constituents and how current measures may be adjusted in subsequent studies to accurately represent behavior change in this population and setting.