A Pre–Post Study of the Feasibility, Acceptability and Benefits of a Co‐Design Approach for the Development of a Digital Suicide Prevention App for International Students

BACKGROUND: Interest in co-design for suicide prevention is growing, yet few studies have evaluated feasibility, acceptability and impact, particularly for culturally and linguistically diverse populations. This study assessed a co-design process used to develop a digital suicide prevention intervention with international students in Australia. DESIGN: We conducted a mixed-methods pre-post evaluation across 10 student and three stakeholder workshops. Participants were 27 international students (57.7% with lived experience of suicidal thoughts and behaviours) from 18 countries and 21 sector stakeholders (education, well-being and student services). Surveys assessed feasibility, acceptability, safety, satisfaction, perceived benefits and confidence in co-design skills. Quantitative data were analysed using descriptive statistics and paired t-tests; open-ended responses were thematically summarised. RESULTS: Workshops were feasible, with high ratings for accessibility, support and safety. International students reported high acceptability and satisfaction, with significant increases in co-design confidence (e.g., collaborating, adapting, participating and influencing outcomes) and perceived benefits (greater mental-health literacy, empowerment, social connection and belonging). Stakeholders reported moderate to high acceptability and valued cross-sector learning and system insights; confidence ratings showed no measurable change. Safety ratings were high for both groups. CONCLUSIONS: Co-design was feasible, acceptable and safe, and associated with benefits for participants. Findings support co-design as a practical, capacity-building approach for developing culturally responsive digital suicide-prevention initiatives for culturally and linguistically diverse populations. PATIENT OR PUBLIC CONTRIBUTION: An expert advisory group of international students with lived experience of suicide provided ongoing guidance. International students and sector stakeholders co-designed the intervention and contributed to planning, design, implementation and review.