Table 2.
Summary of CMO configurations comprising the programme theory for each intervention theme
| Type of intervention | Context (when the intervention works best) | Mechanism (why the intervention works) | Outcome | For whom |
|---|---|---|---|---|
| GSAs or similar student clubs (for example, pride clubs) |
(1) Longer-established clubs (2) Clubs integrated in wider school strategy (3) Schools with positive climate (4) LGBTQ+ teachers attending the clubs and wearing rainbow lanyards |
Reduced homophobia, improved relationships between students, empower SGM students, normalization of being LGBTQ+ → improved school climate | Reduction in self-reported bullying and discrimination | SGM |
| Reduced bullying and safe space for self-expression and social activities | Reduced likelihood of suicidal thoughts and attempts; reduced isolation and increased feelings of safety | SGM students | ||
| Inclusive antibullying and harassment policies |
(1) Longer-established policies (2) Policies being specific to LGBTQ+ issues (3) Supportive school leadership (4) Staff being aware and implementing policies (5) Education and support to bullies (6) Combination of multiple policies in least safe schools |
Reduced homophobia → reduced bullying and stressors → improved school climate | Increased feelings of safety and higher self-esteem; reduced likelihood of self-harm, suicidal thoughts and attempts | SGM students; differential effects for lesbian, gay and bi SGM students |
| Workshops including media interventions |
(1) Workshops held by LGBTQ+ peer educators (2) Media interventions led by LGBGTQ+ students (3) Included in a wider long-term commitment to inclusivity and acceptance by the school |
Increased empathy and understanding towards LGBTQ+ students; awareness of discrimination | Increased inclusivity and acceptance; decreased homophobic and transphobic bullying | SGM students |
| LGBTQ+ ally and staff training |
(1) Training on how to discuss homophobic language use and bullying (2) Sufficient training and resources (3) Training codesigned and codelivered by LGBTQ+ staff and students |
Staff more equipped to implement interventions, provide support and be inclusive towards LGBTQ+ students → increased acceptance, support, treatment, connection and safe learning environments | Less victimization; greater self-esteem, well-being and mental health | SGM students |
| Increased likelihood of discussing, responding to and intervening with homophobic language use and bullying | Increased likelihood of feeling safe and less victimized | SGM students | ||
| Inclusive curricula |
(1) Positive LGBTQ+ representation/role models (2) Avoiding ‘deficit and at-risk’ narratives (3) Education on LGBTQ+ issues (4) Implementation at an early age |
Increased understanding of experiences of LGBTQ+ people, including bullying → acceptance and normalization of being LGBTQ+ and improved school climate | Decreased victimization and bullying and increased intervention with bullying | SGM students, especially severely victimized students |
Key: GSA, gay–straight alliances; LGBTQ+, lesbian, gay, bisexual, trans and queer; SGM, sexual and gender minority; →, is hypothesized to lead to.