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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Mar 20, 2026
Date Accepted: Aug 27, 2026

The final, peer-reviewed published version of this preprint can be found here:

Video Gaming and Psychological Well-Being Among Sexual and Gender Diverse Youth in Canada, the United States, Mexico, the United Kingdom, and Australia: Protocol for a LEVEL UP! Cross-Sectional Survey and Screenshot Elicitation Interview Study

Di Cesare DM, Brooks A, Doll K, McInroy L, Lozano-Verduzco I, Mendoza-Pérez JC, McDermott DT, Perry Y, Schaub J, Byron P, Alessi E, Craig S

Video Gaming and Psychological Well-Being Among Sexual and Gender Diverse Youth in Canada, the United States, Mexico, the United Kingdom, and Australia: Protocol for a LEVEL UP! Cross-Sectional Survey and Screenshot Elicitation Interview Study

JMIR Res Protoc 2026;15:e95804

DOI: 10.2196/95804

Warning: This is an author submission that is not peer-reviewed or edited.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.

Influences of video gaming and online video gaming communities on the psychological wellbeing of sexual and gender diverse youth in Canada, the United States, Mexico, the United Kingdom, and Australia: Protocol for the LEVEL UP! mixed methods study

  • Dane Marco Di Cesare; 
  • Ashley Brooks; 
  • Kaitrin Doll; 
  • Lauren McInroy; 
  • Ignacio Lozano-Verduzco; 
  • Juan Carlos Mendoza-Pérez; 
  • Daragh T McDermott; 
  • Yael Perry; 
  • Jason Schaub; 
  • Paul Byron; 
  • Edward Alessi; 
  • Shelley Craig

ABSTRACT

Background:

Sexual and gender diverse (SGD) youth experience unique minority stressors that can have a significant impact on their wellbeing. Many SGD youth utilize digital technologies to offset these stressors and develop resilience. To date, the role of video gaming in the wellbeing of SGD youth has not been explored.

Objective:

The objectives of the LEVEL UP! study are to: (1) investigate the motivations, preferences, behaviours, and experiences of SGD youth as they relate to video game playing and engagement in online video gaming communities; (2) explore how SGD people are represented in video games and how these portrayals are appraised by young SGD video gamers; (3) identify how video games can support protective factors and processes that contribute to resilience among young SGD video gamers; (4) develop recommendations and resources (e.g., affirming media guides) to make video gaming safer for young SGD people; and (5) demonstrate the utility of video game screenshots as a novel and ecologically valid data source in eliciting discussion from SGD youth about the significance of video gaming in their lives.

Methods:

Mixed methods, cross-sectional survey data from SGD youth aged 14-29 will be collected using the Qualtrics online survey platform in Canada, the United States, Mexico, the United Kingdom, and Australia. A multipronged targeted web-based recruitment approach will be utilized to generate the sample. The survey is divided into six sections: (1) essential demographics and brief screenshot elicitation prompt; (2) video gaming habits, preferences, and playstyles; (3) appraisals of SGD video game content and mechanics; (4) negative experiences as an SGD young person in single and multiplayer video gaming settings and communities; (5) positive experiences as an SGD young person in single and multiplayer video gaming settings and communities; and (6) prize draw and a digital screenshot elicitation interview invitation for Canadian participants. Canadian participants sampled from the survey will be invited to participate in a digital screenshot elicitation interview over Zoom, further elaborating on these experiences.

Results:

Proposed analyses include: (1) descriptive analyses; (2) correlational analyses; (3) multimodal coding of survey screenshot elicitation data; and (4) an integrative constructivist grounded theory of the digital screenshot elicitation interview data.

Conclusions:

LEVEL UP! is planned to be the largest—and to date only international—study of video gaming and psychological wellbeing among SGD youth. It will provide crucial insight into an under-researched digital subculture that may support the resilience of SGD youth. Opportunities for knowledge translation targeting SGD youth, carers, and video game industry professionals are suggested.


 Citation

Please cite as:

Di Cesare DM, Brooks A, Doll K, McInroy L, Lozano-Verduzco I, Mendoza-Pérez JC, McDermott DT, Perry Y, Schaub J, Byron P, Alessi E, Craig S

Video Gaming and Psychological Well-Being Among Sexual and Gender Diverse Youth in Canada, the United States, Mexico, the United Kingdom, and Australia: Protocol for a LEVEL UP! Cross-Sectional Survey and Screenshot Elicitation Interview Study

JMIR Res Protoc 2026;15:e95804

DOI: 10.2196/95804

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