Evaluation design of a novel online suicide intervention for LGBTQ youth

Background: Suicide is one of the top three causes of death among 15 to 24‐year‐olds, and LGBTQ youth are up to four times more likely to attempt suicide than their heterosexual peers. The Trevor Project conducts LGBTQ youth suicide prevention, and approximately 40% of their online social network reported depression within the past year. A process evaluation was designed for TrevorChat, an online crisis de-escalation space for these youth to communicate anonymously with trained counselors. Methods: Literature review and data from The Trevor Lifeline were used to identify quantitative recurring markers of successful crisis de-escalation, and to inform mental health outcomes of interest in this population. A series of key informant interviews with organizational stakeholders were conducted to determine needed quality assurance and program improvement items for evaluation. Three areas were identified: crisis de-escalation, participant demographics and satisfaction. Results: Identified oral crisis de-escalation items were adapted to a written pre- and post-test survey (e.g. intent to hurt oneself or others). The PHQ-9 was selected to provide a clinical measure of depression in addition to demographics to describe the sample. Satisfaction surveys and a system of auditing chat transcripts were created and implemented to inform quality assurance. Conclusion: Communication is rapidly changing from oral to text-based, especially among youth, and interventions aimed at this population must target online mediums. The procedures to design this process evaluation can be taken as a guide to collect data to improve online health interventions such as TrevorChat.