Previously submitted to: JMIR Mental Health (no longer under consideration since Jul 27, 2022)
Date Submitted: Jul 25, 2022
Open Peer Review Period: Jul 25, 2022 - Jul 27, 2022
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Community-based online peer-support and crisis intervention: A mixed methods public health evaluation
ABSTRACT
Background:
Grassroots peer support can be useful when barriers exist to seeking or obtaining mental healthcare. Digital peer support interventions increase access to mental health support and can broaden the reach of evidence-based interventions. Video games and the online communities that spring up around them allow players to connect in a naturalistic community setting and may provide benefits above and beyond those of other grassroots means of support. Although some online communities have developed programs to support the mental health needs of their members, few have been evaluated using a formal program evaluation framework.
Objective:
To evaluate the Stack Up Overwatch Program (StOP) within the context of both peer support and digital health interventions.
Methods:
We used a convergent mixed-methods evaluation design to answer research questions. Data was collected between June and October 2020. Sources of data included surveys of Stack Up Discord server members, interviews with StOP Team members, encounter forms, and chat data from the Overwatch channel. Qualitative data were analyzed using thematic analysis. Chat data was analyzed through content analysis and natural language programming, and descriptive statistics were calculated for quantitative data. After emergent themes were established, the qualitative and quantitative findings were organized in a joint display table and explained through narrative text.
Results:
Data collected included 15, 847 messages from #the-overwatch-channel, 79 survey responses, 112 encounter forms, and 12 Team Member interviews. Of the survey respondents, 57 (72.2%) were military or veterans and 52 (65.8%) were male. Overwatch provides a source of mental health support when other options had been exhausted, and users valued the connections they made with gaming community-member volunteers. Participants reported how the StOP program met their needs for support and connection. Participants also detailed how the form and function of the StOP program facilitates mental health care delivery. Lastly, participants identified some implementation challenges they encountered with the program.
Conclusions:
The COVID-19 pandemic has drawn greater attention to the potential of online spaces as sources of real mental health support. Community-based crisis prevention programs administered through chat may be a valuable way to support both users and volunteer providers, especially when peer support is provided in a naturalistic setting. Organizations seeking to adapt or implement programs should plan for monitoring and evaluation from program inception to ensure quality and build an evidence base.
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