{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:15:15Z","timestamp":1785885315662,"version":"3.56.0"},"reference-count":9,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Cancer Center Support Grant","award":["CCSG, P30CA015704"],"award-info":[{"award-number":["CCSG, P30CA015704"]}]},{"name":"Cancer Center Support Grant","award":["National Institutes of Health \/ U54CA132381"],"award-info":[{"award-number":["National Institutes of Health \/ U54CA132381"]}]},{"name":"Cancer Center Support Grant","award":["Safeway Early Career Award in Cancer Research"],"award-info":[{"award-number":["Safeway Early Career Award in Cancer Research"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>Tailored tobacco cessation interventions focusing on minoritized communities are proliferating, but the extent to which these interventions address the needs of individuals with multiple minoritized social identities is unclear. We developed Empowered, Queer, Quitting, and Living (EQQUAL), an avatar-led digital smoking cessation intervention tailored for lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and more (LGBTQIA+) young adults based on acceptance and commitment therapy (ACT), via a multistage user-centered design process. The purpose was to evaluate feedback from EQQUAL development activities using an intersectional lens. Intersectionality is a paradigm created by Kimberl\u00e9 Crenshaw illustrating the multiple social identities each person possesses along with the marginalization of these different social identities. We conducted a rapid deductive content analysis focused on intersectional design gaps using interviewer notes from user testing ( n = 7), a diary study ( n = 8), and treatment satisfaction responses from a single-arm trial of the EQQUAL intervention ( n = 22). Feedback related to intersectional design fell under three broad themes: (a) inadequate representativeness of the avatar, (2) inadequate representativeness within the program broadly, and (3) non-inclusive ACT intervention content. Feedback on inclusiveness included reference to socioeconomic status, race\/ethnicity, religious\/cultural affiliation, and ability\/disability. Although we previously found that EQQUAL was highly acceptable and showed promise in terms of efficacy in a single-arm pilot trial, we identified several gaps in intersectional design as the iterative intervention development proceeded. Because intersectional design is a critical part of developing interventions with a health equity focus, applying standardized procedures for intersectional design and analysis could improve intervention design and better address tobacco cessation treatment needs of individuals who may experience multiple forms of marginalization.<\/jats:p>","DOI":"10.1177\/15248399221141693","type":"journal-article","created":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T02:08:47Z","timestamp":1672366127000},"page":"391-394","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Intersectionality in Intervention Development: Insights From Formative Work on a Tailored Tobacco Cessation Program for LGBTQIA+ Young Adults"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3446-3973","authenticated-orcid":false,"given":"Tamara","family":"Stimatze","sequence":"first","affiliation":[{"name":"New Mexico State University, Las Cruces, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond A.","family":"Ruiz","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3790-4831","authenticated-orcid":false,"given":"Isela","family":"Garcia","sequence":"additional","affiliation":[{"name":"New Mexico State University, Las Cruces, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan M.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Edith Nourse Roger Memorial VA Hospital, Bedford, MA, USA"},{"name":"University of Massachusetts Medical School, Bedford, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edit","family":"Serfozo","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin D.","family":"Reilly","sequence":"additional","affiliation":[{"name":"Edith Nourse Roger Memorial VA Hospital, Bedford, MA, USA"},{"name":"University of Massachusetts Medical School, Bedford, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniella","family":"Kim","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NFN","family":"Scout","sequence":"additional","affiliation":[{"name":"National LGBT Cancer Network, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Karekla","sequence":"additional","affiliation":[{"name":"University of Cyprus, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaimee L.","family":"Heffner","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"bibr1-15248399221141693","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.01.032"},{"key":"bibr2-15248399221141693","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11449-6"},{"key":"bibr3-15248399221141693","doi-asserted-by":"publisher","DOI":"10.2196\/30241"},{"key":"bibr4-15248399221141693","doi-asserted-by":"publisher","DOI":"10.1007\/s10964-021-01443-x"},{"key":"bibr5-15248399221141693","doi-asserted-by":"publisher","DOI":"10.1080\/01639625.2019.1572095"},{"key":"bibr6-15248399221141693","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntac110"},{"key":"bibr7-15248399221141693","unstructured":"U.S. National Cancer Institute. (2017). A socioecological approach to addressing tobacco-related health disparities. National Cancer Institute Tobacco Control Monograph 22 (NIH Publication No. 17-CA-8035A). https:\/\/cancercontrol.cancer.gov\/sites\/default\/files\/2020-08\/m22_complete.pdf"},{"key":"bibr8-15248399221141693","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntz184"},{"key":"bibr9-15248399221141693","doi-asserted-by":"publisher","DOI":"10.1111\/jora.12488"}],"container-title":["Health Promotion Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15248399221141693","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15248399221141693","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15248399221141693","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:25:05Z","timestamp":1777451105000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15248399221141693"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,29]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1177\/15248399221141693"],"URL":"https:\/\/doi.org\/10.1177\/15248399221141693","relation":{},"ISSN":["1524-8399","1552-6372"],"issn-type":[{"value":"1524-8399","type":"print"},{"value":"1552-6372","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,29]]}}}