Assessment Visits:
As part of this study, adolescents will participate in four assessment visits at baseline
and 4, 12, and 24 weeks following onboarding to the study intervention. Assessments cover
a range of topics including mood, anxiety, suicidal thoughts and behaviors, and social
media use and experience. At the time of the baseline visit, youth will be selected to
receive either Flourish+Questionnaires (intervention condition) or Questionnaires Alone
(control condition). Selection will occur through randomization, referring essentially to
asking a computer to "flip a coin" to decide which group the participant will be assigned
to.
Control Condition: Questionnaires Alone Youth in the control condition will be onboarded
to a chatbot by a study clinician. A chatbot refers to an automated intervention that
leverages chat-based conversations to communicate intervention content. This chatbot is
designed solely to send structured brief questionnaires about online interactions via
text messaging. Questionnaires assess the presence of negative/bullying interactions and
positive/supportive interactions, once every 3 days. Mirroring the intervention
condition, youth will receive this simplified chatbot for 4 weeks. If youth endorse
negative/bullying interactions, they will be provided with information for crisis
contacts (e.g., crisis hotline information).
Intervention Condition: Flourish Flourish is a chatbot that will aim to improve
adolescents' capacity to cope following cyberbullying and reduce their suicidal risk. The
duration of Flourish is 4 weeks. Flourish is designed to be self-paced with branching
logic, aiming to provide the right type of support at the right time youth need it.
Therefore, the frequency with which youth interact with Flourish will differ from person
to person. However, participants are expected to interact with Flourish approximately 2-3
times per week.
Onboarding to Flourish. Prior to initiating Flourish, adolescents and their caregivers
will participate in a session of approximately 30 minutes with a study clinician in which
they will onboard to Flourish. During onboarding, the clinician will orient the
adolescent to Flourish and load information onto Flourish that will be available to the
adolescent throughout their use of the intervention. This will include personal crisis
contacts, such as trusted adults and crisis hotlines they could contact in the event of a
crisis, as well as contacts for people they could reach out to for support or distraction
outside of a crisis situation, such as a close friend or a family member. Adolescents
will additionally enter information to personalize their experience with Flourish, such
as entering preferences for coping skills that work best for them. During the onboarding
process, caregivers will be provided with resources to respond to cyberbullying as well
as information on their child's personal crisis resources.
Questionnaires through Flourish. Youth in the intervention group will receive
questionnaires evaluating online experiences mirroring those received by the control
group. If adolescents indicate negative interactions, Flourish will automatically launch
providing supportive resources including crisis resources. If adolescents indicate
supportive interactions (or no interactions), they will be given the option to launch
Flourish to practice their coping skills, so they are prepared to respond to future
cyberbullying events.
Resource Website for Flourish. Participants receiving Flourish will also have access to
an accompanying website. The website will not collect or store any private information
from the participant, and the participant will not interact with the website. It is a
publicly available website that provides a list of resources participants may use, if
needed. For example, this will include youth mental health organizations and
organizations that provide education, support, and advocacy for youth who have
experienced cyberbullying.
Social Media Data Collection and Feedback. Youth in both groups (Flourish+questionnaires
and Questionnaires Alone) will have the option to provide their social media archives as
part of the study. Software will strip identifiable information (e.g., names, dates of
birth, locations, etc.) to the extent possible from the archives. Archives will be
analyzed using software that detects presence of positive and negative social
interactions. Those assigned to Flourish+Questionnaires will receive feedback from their
online interactions, which is anticipated to help youth gain recognition and awareness of
their online environment.
