Suicide is a major public health concern and there is a need for accessible and scalable interventions to support individuals experiencing suicidal thoughts. The aim of this study is to develop a digital Acceptance and Commitment Therapy (ACT) intervention for suicide prevention in Chinese adults through co-design. The study will involve literature review, interviews, and co-design activities to identify user needs, preferences, and contextual factors, and to develop the intervention. Following intervention development, a pilot study will be conducted to evaluate the feasibility, usability, acceptability, and user engagement of the intervention. Findings from this study will inform further refinement of the intervention and future evaluation studies.
Lived experience participants
Aged 18 years or older;
Have experienced suicidal thoughts and/or behaviors;
Able to read and communicate in Chinese; Professionals
Unable to provide informed consent or participate in study activities;
Currently experiencing acute suicide risk requiring immediate intervention;
Severe cognitive impairment or active psychotic symptoms that would prevent participation.
Single group
Digital ACT Intervention
BehavioralA co-designed digital Acceptance and Commitment Therapy (ACT) intervention for suicide prevention
Intervention completion rate
The intervention completion rate will be assessed as the percentage of participants who complete the digital intervention, based on intervention usage records.
Retention rate
The participant retention rate will be assessed as the percentage of participants who complete the post-intervention assessment and the follow-up assessment.
Acceptability outcome
Acceptability of the intervention will be assessed using participant-reported ratings and feedback regarding satisfaction and overall experience with the intervention.
Usability outcome
Usability will be assessed using the System Usability Scale (SUS), a 10-item self-report questionnaire. Total scores range from 0 to 100, with higher scores indicating better usability of the intervention.
Suicide ideation
Suicidal ideation will be assessed using the Beck Scale for Suicide Ideation (BSSI). Each item is rated on a 3-point scale ranging from 0 to 2, with higher scores indicating greater suicidal ideation.
Psychological flexibility and inflexibility
Psychological flexibility and inflexibility will be assessed using the Multidimensional Psychological Flexibility Inventory-24 (MPFI-24). Each item is rated on a 6-point scale ranging from 1 to 6. Higher scores on the flexibility and inflexibility subscales indicate greater psychological flexibility and psychological inflexibility, respectively.
Psychological Distress
Psychological distress will be assessed using the Depression Anxiety Stress Scales (DASS). Each item is rated on a 4-point scale ranging from 0 to 3, with higher scores indicating greater psychological distress.
Mental well-being
Mental well-being will be assessed using the Mental Health Continuum-Short Form (MHC-SF). Each item is rated on a 6-point scale ranging from 0 to 5, with higher scores indicating greater mental well-being.
Qualitative Feedback and Design Recommendations
Qualitative feedback related to user needs, preferences, barriers, facilitators, cultural considerations, and recommendations for intervention refinement will be identified from co-design activities and feedback sessions.
Cultural Relevance
Cultural relevance of the intervention will be assessed through participant feedback regarding the appropriateness, relevance, and cultural fit of the intervention content and delivery.
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