Evaluation of the SignPost Study: a mobile phone messaging intervention to support people bereaved by suicide

The SignPost study is an evidence-informed brief contact intervention comprising a series of text messages for people bereaved by suicide. Messages will be sent over a six-week period to participants (18 years or over) bereaved by suicide and will contain information and links to readily available supports and psychoeducation about grief following suicide. A randomised controlled trial will be used to investigate the efficacy of the intervention. Participants will be randomly allocated to either an intervention group or the control (i.e., treatment-as-usual) group. The intervention group will receive a series of SMS brief contacts over a six-week period, provided in addition to treatment as usual. The messages will link to a Webpage hosted on Qualtrics and include a links to Factsheets relevant to the topic of the message. The specific content and framing of the messages and the type of content provided have been developed through a two-phase collaborative method. First, international experts in suicide prevention provided input into the issues and timing of these issues, and second, the outcomes of this were reviewed through focus groups with people with lived experience of suicide bereavement to finalise the message content. This study will use a mixed-methods approach to evaluate the effectiveness of the intervention with survey assessments conducted at baseline (T1) and six-week post-baseline (T2), with qualitative interviews conducted after the intervention period with a subset of participants. Messages are sent via SMS at the following timepoints across a six week period, with the subject identified: Message 1 @T1 + 1 day - grief after suicide Message 2 @ T1 + 8 days - practical challenges Message 3 @ T1 + 15 days - relationships after a suicide Message 4 @ T1+22 days - I need help now Message 5 @ T1 + 25 days - returning to well-being Message 6 @ T1 + 29 days - peer support Message 7 @ T1+ 26 days - professional support Link to T2 @T1 + 39 days The length of the messages is between 100-150 words, taking 1-2 minutes to read. The development of the messages was two-phased. First, a group of international suicide bereavement experts completed a survey indicating the issues/challenges associated with suicide bereavement, and what supports were required at differing timeframes following the death. This informed focus groups undertaken with people bereaved by suicide who then developed and tested the messages and landing website information. Further information for the website was sourced through existing services, primarily the national suicide postvention program, StandBy Support After Suicide (https://standbysupport.com.au/resources/) to refer specifically to the content of the message. The information designed specifically for the study is not yet publicly available, until after the trial so that the control condition do not have access. Post this study the information will become publicly available and will be hosted on the Life in Mind website (www.Lifeinmind.org.au). As the landing website is designed specifically for this study, general tracking analytics of the website use are being collected. The qualitative interview participants will be purposively sampled based on the initial quantitative analysis to ensure maximum variation sampling to ensure insights into those who used the messages and website, and those who did not based on changes to the primary and secondary outcome measures.