Suicidal Behavior, Suicidal Ideation
Conditions
Keywords
adolescents, young adults, suicide prevention, health services research
Brief summary
The goal of this clinical trial is to evaluate an app to help keep teens and young adults with suicidal thoughts safe. The app includes a safety plan created by adolescents and healthcare providers, and videos to encourage supportive communication and skills for teens and young adults to stay safe. The main question it aims to answer is whether the use of an app can increase youth suicide-related coping for youth with suicidal ideation, parent/caregiver suicide prevention self-efficacy, and healthcare provider self-efficacy in suicide management. Researchers will compare usual care to usual care with the app. Participants, including adolescents, caregivers, and healthcare providers, will use the ISSP app (if assigned to that group) and view video content and complete three online surveys.
Detailed description
The current study aims to evaluate the Jaspr app relative to usual care among youth (ages 13-21 years) who indicate suicidal ideation in pediatric medical settings. The Jaspr app includes supported safety planning between the young person and the healthcare provider, as well as skills and support videos for youth and caregivers intended to increase coping and decrease distress with an opportunity to access these resources through an at home app. Adolescents, parents, and clinicians will participate in the project to assess the effectiveness of Jaspr augmenting usual care, compared to usual care alone. The study will use a pre-post design in which each setting begins with a control period and then transitions to the addition of Jaspr following healthcare provider training on use of the app. Participants and their parents/caregivers will receive study assessments at baseline, 1-month, and 2-month follow up timepoints, and healthcare providers complete a survey at baseline, and the end of each period (control and intervention). Study assessments with youth will ask about coping, suicidal ideation and severity, anxiety and depression, service utilization, functional impairment, access to lethal means, and acceptability of the app. Study assessments for parents/caregivers will ask about their self-efficacy in managing their youth's suicidality, acceptability of the videos/app, and service utilization for the youth. Healthcare providers will complete surveys assessing their self-efficacy in managing youth suicidality and feasibility of use of the app. Youth, their legal guardian, and healthcare providers each assent/consent to participate in the research procedures.
Interventions
OTHERIntegrated skills and safety planning app
This is a digital app that includes supported safety planning resources in medical settings as well as coping skills and lived experience videos for adolescents, young adults and parents/caregivers that can be accessed while in the medical setting or at home.
Sponsors
University of Washington
National Institute of Mental Health (NIMH)
Seattle Children's Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
This trial will use a pre- post- sequential design in which each clinic has a control period (usual care), followed by provider training, and then an intervention period (usual care plus Jaspr app).
Eligibility
Sex/Gender
ALL
Age
13 Years to 21 Years
Healthy volunteers
No
Inclusion criteria
Youth Inclusion Criteria: * Age 13 -21 years, an Ask Suicide Questions (ASQ) screen score of 1-5 with active ideation (not solely a history of a prior attempt) but no current plan or intent, or patient-reported suicidal thoughts and behaviors during a clinical assessment in a medical setting who are judged by a clinician to be appropriate for conducting higher level assessment in that setting (including a BSSA and/or safety planning) in order to support care at home. * Parents/guardians: One "parent" per AYA will also be invited to participate. * HCPs: All HCPs in participating settings who may conduct assessments of SI and safety planning (physicians, nurse practitioners/physician's assistants, social workers, mental health counselors, psychologists) will be invited to participate. * All subjects must have access to the internet and a computer or tablet device. Youth
Exclusion criteria
* Concurrently enrolled in an affiliated Suicide Care Research Center study, no phone access, or non-English speaking.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Youth Suicide-Related Coping | Baseline, 1 month, 2 month | Total Score on the 17-item Youth Suicide-Related Coping Scale |
| Parent suicide prevention self-efficacy | Baseline, 1 month, 2 month | Total score on the Parent suicide prevention self-efficacy scale |
| Healthcare provider self-efficacy in suicide management | Baseline, end of control period, and end of intervention period | Total score on the Provider suicide Intervention Questionnaire |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Safety Plan Quality | Up to 1 month | Safety Planning Scoring Algorithm (SPISA) based on youth medical chart review |
| Youth Suicide Severity | Baseline, 1 month, 2 month | Total score on the online self-report version of the Columbia Suicide Severity Rating Scale (C-SSRS) |
| Youth Anxiety Symptoms | Baseline, 1 month, 2 month | Total Score on Youth Self-Reported Generalized Anxiety Disorder -7 item scale |
| Intervention Acceptability | Baseline, 1 month, 2 month | Youth and Parent Report on the Acceptability of Intervention Measure (AIM) |
| Functional Impairment | Baseline, 1 month, 2 month | Total score on the youth reported EQ-5D-Y quality of life measure |
| Youth Suicidal ideation | Baseline, 1 month, 2 month | Total Score on the Harkavy Asnis Suicide Scale ideation subscale (HASS-I), |
| Youth Depressive Symptoms | Baseline, 1 month, 2 month | Total score on the Patient Health Questionnaire 9 |
Countries
United States
Contacts
CONTACTLaura Richardson, MD, MPH
PRINCIPAL_INVESTIGATORLaura Richardson, MD, MPH
University of Washington
Outcome results
None listed