Co-Design and Development of an Internet Search Intervention using Google AdWords for Individuals Contemplating Suicide: The Lived Experience Hope Exchange

<p>Background: Suicide is a recognized public health issue, with approximately 800,000 people dying by suicide each year. Past findings suggest that individuals may search for suicide-related terms prior to an attempt. Therefore, we may be able to use internet ads to interrupt their search process to promote help seeking. Further, lived experience co-design has been used to develop effective and engaging products. Objective: The primary objective of this study was to co-design and develop internet search advertisements and web pages targeting individuals searching for suicide related terms. The secondary objective is to outline lived experience engagement methods in line with co-design principles. Methods: To inform the design of the intervention, two lived experience advisory groups were established. Together, we conducted a series of co-design workshops split by age groups asking participants what individuals are likely to search for when contemplating suicide, what advertisements are likely to encourage clicking through, and what would or would not be helpful on the web pages and modules. This process involved several rounds with varying methods to ensure our intervention captured the vision of the lived experience advisors and was in line with current literature.Results: The list of keywords generated included means-specific keywords, help-seeking keywords, general crisis-related keywords, and general contemplation-related keywords. Participants clearly stressed that the intervention should communicate clearly that it was developed by lived experience persons and that it was for individuals with lived experience. Modules requested included hearing community stories, easily digestible information and resources, along with calming and distracting activities. Further, different age groups had stark differences in their needs and preferences for the keywords, web pages, and associated modules. For example, while the younger age group asked for distracting resources, the older age group specifically noted it would not be helpful. Across all areas, the lived-experience advisors emphasized respect for agency, and diversity of options. Conclusion: The current intervention targets individuals searching for suicide related-terms on Google by presenting an advertisement to a web page with a range of varying resources. It has the potential to provide accessible and cost-effective support for individuals who may not otherwise reach out for help. A randomized controlled trial of this intervention is underway.</p>