Self-Harm, Suicidal Ideation, Suicide Attempt
Conditions
Keywords
suicide, self-harm, attempt, ideation, suicidal thought, suicidal plan, crisis intervention, suicide prevention, emotional support, mental health, behavioral health, technology, mobile application, lethal means, safety plan
Brief summary
Mobile-based applications, such as JasprHealth, can deliver evidence-based skills intended to reduce imminent suicide risk (e.g., reducing means access), improve emotional states (e.g., via distraction and coaching to act opposite to emotions), and reduce feelings of social isolation (e.g., via shared stories), but user engagement is a barrier. The aim of this study was to examine the effects of a technological application resource (Jaspr) relative to human augmentation (Jaspr+, e.g., motivationally focused orientation plus prompts) on acceptability, preliminary effectiveness, and engagement among college students who screen positive for suicide risk.
Detailed description
Mobile-based applications, such as Jaspr Health, can deliver evidence-based skills intended to reduce imminent suicide risk (e.g., reducing means access), improve emotional states (e.g., via distraction and coaching to act opposite to emotions), and reduce feelings of social isolation (e.g., via shared stories). Although mobile-device-delivered interventions hold the potential to make interventions widely accessible, user engagement presents a substantial barrier to efficacy. This study, ASSIST: Advancing Student Suicide Interventions with Scalable Technologies, aims to improve engagement with mobile-delivered suicide prevention applications, with the ultimate goal of reducing suicidal thoughts and behaviors in college students. Including human elements alongside Jaspr Health has the potential to improve the uptake of this evidence-based, accessible mobile-device-delivered intervention. The aim of this study was is to examine the effects of the technological application resource Jaspr tablet application with access to Jaspr at Home (JAH) vs. Jaspr+ human augmentation (e.g., motivationally focused orientation plus prompts) on acceptability, preliminary effectiveness, and engagement among 50 college students who screen positive for suicide risk (n=25 per condition) over the course of 2 months. Candidate mechanisms (e.g., coping skills, self-stigma) will also be assessed. Participants were randomized via the Redcap randomization module, stratified by site.
Interventions
DEVICEJaspr
With assistance from a research staff, the subject will complete self-administered suicide risk assessment on the tablet via Jaspr app, then the subject will engage with suicide-related coping skills and resources that the app provides. Subjects will continue to have access to the coping skills and videos via a mobile app.
BEHAVIORALBehavioral support
Jaspr conversations will be augmented human-driven behavioral support. Conversations will be guided by motivational interviewing principles. Subjects can sign up to receive JAH mobile app. Subjects will be prompted with their personalized goals as reminders to use the Jaspr app.
Sponsors
University of Wisconsin, Madison
University of Massachusetts Chan Medical School, Worcester
National Institute of Mental Health (NIMH)
University of Massachusetts, Amherst
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Recent suicidal thoughts or behavior (i.e., past 2-week suicidal ideation or past 6-month suicidal behaviors) * Current UMass Amherst or University of Wisconsin Madison undergraduate student * 18 years of age or older * Ability to understand written or spoken English * Owning a mobile device * Ability to understand and consent to study procedures
Exclusion criteria
* No recent suicidal thoughts or behaviors (i.e., past 2-week suicidal ideation or past 6-month suicidal behaviors) * Not a current UMass Amherst or University of Wisconsin Madison undergraduate student * Under 18 years of age * Inability to understand written or spoken English * Does not own a mobile device
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Suicidal ideation | weeks 0, 4, 8 | Assessed with Suicide Ideation Questionnaire \[SIQ\], with higher scores reflecting greater past month suicidal ideation. |
| Suicidal behaviors | weeks 0, 1, 2, 3, 4, 8 | Assessed with the Columbia-Suicide Severity Rating Scale \[C-SSRS\] self-report screen past week (y = presence /n) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Satisfaction with Intervention | weeks 0, 4, 8 | Assessed with the Client Satisfaction Questionnaire - 8 \[CSQ8\], with higher scores reflecting greater satisfaction with the intervention. |
| Ways of coping | weeks 0, 4, 8 | Assessed with the DBT-Ways of Coping Checklist (DBT-WCCL), which yields scales of skills use, general dysfunctional coping, and blaming others, with mean scores of 0-3, with higher levels indicating greater use of those strategies. |
| Suicide-related coping | weeks 0, 4, 8 | Assessed with the suicide-related coping scale, \[SRCS\] with higher scores reflecting a better ability to cope with suicidal thoughts |
| Self-reported engagement | weeks 0, 1, 2, 3, 4, 8 | Assessed with item developed for this study, with higher scores reflecting greater engagement in the app. |
| Suicide stigma | weeks 0, 4, 8 | Assessed with the personal suicide stigma questionnaire \[PSSQ\], with higher scores reflecting greater stigma. |
| Acceptability | weeks 0, 4, 8 | Assessed with the Acceptability of Implementation Measure \[AIM\], with higher scores reflecting whether the intervention is liked, welcomed, or approved. |
Countries
United States
Outcome results
None listed