eCREST: A Methodological, Ethical, and Data Integrity Framework for Anonymous Online Suicide Research With Diverse Adolescents

Objective Suicide rates among Black and multiracial adolescents have increased in recent years, yet racially diverse youth remain underrepresented in suicide research. Anonymous online recruitment may improve equity; however, rigorous ethical safeguards and data integrity procedures are necessary. This protocol describes the Examining Culturally Relevant Experiences in Self-Harm for Teens (eCREST) study, an anonymous online study designed to recruit a diverse US adolescent sample and to provide an ethically grounded, reproducible framework for suicide research. Method eCREST enrolled adolescents 13 to 17 years of age using social media advertising and community outreach targeting diverse populations. Participant protections included embedded youth-tailored crisis resources, mid-and-exit-surveys assessing distress and suicidal ideation, and the option to discontinue at any time. Multilayered data integrity procedures included both detection thresholds, cross-survey data matching, survey randomization, and stringent completion metrics. The survey incorporated developmentally and culturally adapted measures, supplemented by open-ended responses. Cultural and developmental appropriateness were enhanced through expert review, confirmed readability metrics, and adolescent piloting. We recruited 893 adolescents between August 2023 and January 2025. Our sample was racially and ethnically diverse, with 62% of adolescents identifying as Black. Despite not enriching the sample for adolescents with histories of suicidal thoughts and behaviors, approximately 72% endorsed lifetime suicidal ideation, and 27% reported a lifetime suicide attempt. The majority of participants (88.2%) indicated no increase in suicidal desire, and no safety concerns, complaints, or imminent risk communications were reported. Adapted and newly developed measures demonstrated good-to-excellent internal consistency (α = 0.66-0.98; ω = 0.87-0.99). Finally, our multistep data quality procedures removed 6,418 possible fraudulent, bot, or duplicate responses. Discussion eCREST demonstrates the feasibility of conducting inclusive, anonymous online suicide research with adolescents. This protocol offers a model for expanding equitable participation in suicide research and for responsibly leveraging digital platforms to reach high-risk youth. Study registration information Examining Culturally Relevant Experiences in Self-Harm for Teens (eCREST); https://osf.io/y93rx/overview Diversity & Inclusion Statement We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.