Procedures
psychiatric, psychotic disorder
RECRUITMENT
Following randomization, participants were asked to complete the online baseline questionnaire and to choose their time slots to participate in the group discussion based on their schedules. Researchers then grouped participants according to their selected time slots. Each group, consisting of 4 to 6 participants, was assigned 1 researcher as the group facilitator to help participants complete all the intervention procedures. The entire intervention was conducted on an online video conferencing platform (Tencent Meeting, a conference software with functions very similar to ZOOM). Each participant received the encrypted online meeting link of one’s group and was notified to attend the meeting as scheduled. Due to the sudden changes in the schedules or dropouts, there were 2 groups that had only 3 participants.This digital online-based intervention has incorporated 3 key therapeutic components, including (1) online animated psychoeducational videos (The current intervention was developed by the study team. Regarding the intervention videos, 5 modules in the intervention video were all presented from the perspective of LGBTQ+ populations, and the characters used were LGBTQ+ friendly. The intervention video also contains LGBTQ+-friendly doctors and practitioners in the psychology and psychiatry fields and 2 role models from the LGBTQ+ community (1 homosexual and 1 transgender). Regarding facilitator-led group discussions, structured interview guidelines were created by the supervisor of the project and were printed out during group discussions. During facilitator-led group discussions, 3 facilitators acquired participants’ verbal consent and introduced confidentiality to them. The help-seeking brochure was graphically designed by one of the research assistants. Its content included LGBTQ+-friendly knowledge and help-seeking resources. As mentioned in our study protocol [Regarding the intervention process, group facilitators delivered this brief digital online-based multicomponent intervention by leading participants in completing the following 3 essential steps: (1) watching the entire 15-min intervention video (i.e., videos in both conditions were of the same length) with other group members in the online conference room; (2) actively participating in the structured discussions regarding intervention video and electronic psychoeducational brochure with other participants in the online conference room; and (3) freely accessing and reviewing the intervention video and electronic brochure post-discussion via web link given.All 3 facilitators of the current study had a master’s degree in psychology and received 7 times internal training (2 to 3 h for each training) from 2 senior researchers (a doctoral degree in psychology and a doctoral degree in psychiatry research) before the start of the study (see investigators training section in appendix). The intervention process was recorded and checked to ensure intervention fidelity. Two senior researchers listened to the recordings of the intervention procedure independently and evaluated the fidelity of facilitators. The fidelity evaluation using a list developed by the research team, which included 6 items assessing video fluency, facilitators’ involvement, facilitators’ friendliness, participants’ activity, participants’ emotional involvement, and the overall evaluation of the process. Each item scored 0 to 5, using the average score of 6 items to evaluate the completion of a group discussion. Two senior researchers each listened to 6 recordings, including 3 intervention group recordings and 3 control group recordings from 3 facilitators, respectively. The average fidelity scores given by the 2 senior researchers were from 4.58 to 4.67 (full score of 5 points).Intervention videos for both conditions were safely stored in a password-protected online server at Wenjuanxing, a Chinese online survey platform (i.e., similar to To ensure the safety of participants, we have developed a directory consisting of a list of psychiatric hospitals and their appointment registration methods in many cities in China, online and offline psychological intervention resources, and a list of the main Chinese crisis helplines. For participants who were excluded due to psychotic disorder or high suicide risk in the recruitment stage, we provided them with the directory and advised them to seek professional help. For participants involved in this study, whether in the intervention condition or control condition, the end of the brochures they received was also attached with the same directory mentioned above so they can get professional help at any time through this information if they need it. Ethical approval was granted by the Institution Review Board of Tsinghua University (Approval No. 20210146).