Accepted for/Published in: JMIR Formative Research
Date Submitted: Jul 18, 2025
Open Peer Review Period: Jul 21, 2025 - Sep 15, 2025
Date Accepted: Feb 2, 2026
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Using Discord to Engage LGBTQ+ Youth in Human-Centered Design of a Digital Mental Health Intervention: A Methods Case Study
ABSTRACT
Background:
Background:
LGBTQ+ (i.e., lesbian, gay, bisexual, transgender/gender diverse, queer) youth experience significant health challenges relative to their peers, including higher rates of HIV, STIs, and mental health symptoms, partly due to minority stressors. Digital health interventions hold promise for addressing these issues, but their effectiveness hinges on human-centered co-design to ensure relevance and engagement.
Objective:
Objective:
This study examines the use of Discord as a platform for conducting human-centered design activities to adapt a digital text-based intervention aimed at improving HIV testing rates among LGBTQ+ youth.
Methods:
Methods:
We recruited 21 LGBTQ+ youth (ages 13–18) in the U.S. via social media and participant registries, oversampling minoritized gender, racial, and ethnic identities to ensure diverse representation. Over 10 months, participants engaged in structured HCD activities on a private Discord server, including polls, open-ended discussions, and interactive feedback tasks. Design insights were collected iteratively and used to refine the intervention in real time. We also surveyed participants to examine the acceptability of Discord as a tool for hosting the HCD process.
Results:
Results:
We identified best practices for integrating HCD methods within Discord, including co-creating the server environment with participants and enabling real-time iteration of intervention components based on youth input. The privacy of the Discord server supported psychological safety, open and effective communication between participants and the research team, and fostered an informal, familiar atmosphere.
Conclusions:
Conclusions:
Discord provides an effective and acceptable environment for conducting HCD processes in digital health intervention design. Its structural features, including anonymity, accessibility, and community-driven interaction, facilitated meaningful youth engagement in co-design activities. These insights offer a model for leveraging social media platforms to enhance participatory intervention development for LGBTQ+ populations.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.