Development and Feasibility Testing of a Suicide Prevention Intervention for Sexual and Gender Minority Youth

More than half of sexual and gender minority youth (SGMY) have considered suicide, the second leading cause of death among youth, and SGMY experience cyberbullying at nearly three times the rate of non-SGMY. There is a strong public health need to reduce the impact of cyberbullying among SGMY because of its association to known risk factors for suicide among SGMY. However, to our knowledge, there are currently no evidence-based suicide prevention interventions for cyberbullied SGMY. Cyberbullying is strongly linked to suicidal ideation, a phenomenon known to fluctuate rapidly, which suggests the need to intervene proximally to cyberbullying to reduce suicidal risk. Following cyberbullying, SGMY experience elevated levels of distress and face barriers to help-seeking, which if augmented could offer critical linkages to support and care that could reduce SGMY suicidal risk. The purpose of this American Foundation for Suicide Prevention Young Investigator Innovation Grant is to bridge this important gap in suicide prevention for cyberbullied SGMY. This work will be led by Dr. Biernesser (PI), a trained behavioral health scientist and clinical social worker, who is experienced in the development of digital interventions and has expertise on social media's influence on adolescent suicidal risk. Dr. Escobar-Viera (Co-I) is a health services researcher and psychiatrist with expertise on digital interventions to support SGMY mental health. This research will be mentored by Dr. Tina Goldstein, a widely recognized expert on the study and treatment of adolescent suicidality with specific expertise on psychosocial treatment development for mood-disordered and suicidal youth. She has a consistent track record for mentoring early career scholars to high impact careers in suicide research. Additionally, a team of consultants, Drs. Espelage, Farzan, and Iyengar, will offer guidance for this project through their expertise on cyberbullying among SGMY, as well as participatory design and data analytic methods, respectively. Together, this team will develop imHere4U, a just-in-time digital suicide prevention intervention that will respond following SGMY's experiences of cyberbullying, detected by a social media-based algorithm, to support adaptive coping responses and motivation for help-seeking. Aim 1: This research plan will proceed by first discovering SGMY's (N=20), parents of SGMY's (N=10), and professional's (N=10) parameters for an acceptable intervention using qualitative interviews. Aim 2: Subsequently, 15 SGMY who have experienced cyberbullying will participate in an iterative process of designing and building intervention content to optimize a digital product for their needs and preferences. Aim 3: Finally, 10 adolescents with a past-month history of cyberbullying will participate in an open clinical trial. This trial will aim to test the feasibility and acceptability of imHere4U, essential data for a subsequent R01 application to test the efficacy of imHere4U within a larger sample as well as dissemination outcomes. Results from this area of investigation are expected to lead to an efficacious intervention that fills a critical gap in service delivery for SGMY by intervening when and where cyberbullying occurs to prevent SGMY suicidal risk.