Autism, Suicide Prevention
Conditions
Keywords
Autism, Suicide Prevention, Safety Planning Intervention, Pediatric Clinics
Brief summary
The goal of this clinical trial is to examine the initial feasibility, acceptability, and effectiveness of Crisis Interventions for Pediatric Providers - Autism version (CIPP-A) for providers serving autistic youth in outpatient settings. The main question aims to answer: * Assess whether CIPP-A is feasible and acceptable to providers in development behavioral pediatric clinics? * Assess whether CIPP-A shows initial effectiveness in increasing providers confidence in managing suicide risk in autistic youth? If there is a comparison group: Researchers will compare CIPP-A to general safety planning intervention (SPI) on feasibility, acceptability, and initial effectiveness. Participants will be randomized to receive training in SPI or CIPP-A and complete online surveys and interviews over 6-months to measure feasibility, acceptability, and initial effectiveness.
Interventions
BEHAVIORALSafety Planning Intervention
The Safety Planning Intervention (SPI) is leading, evidence-based intervention that manages risks associated with suicidal thoughts and behaviors in youth. The SPI is delivered by providers to youth and their parents/guardians and focuses on teaching the family a series of safety planning steps to keep youth safe as they experience suicidal thoughts and/or behaviors. The SPI can be delivered by providers to families in person or virtually during clinic visits, and shows effectiveness in increasing child safety. Further, the SPI is a flexible intervention that can be delivered by a variety of healthcare professionals (e.g., pediatricians, social workers, nurses, etc.). The SPI has been found to be effective when delivered in emergency, inpatient, and outpatient settings; in this study, the SPI will be delivered by providers in Developmental-Behavioral Pediatric (DBP) settings.
BEHAVIORALCrisis Interventions for Pediatric Providers - Autism version (CIPP-A)
The CIPP-A is an autism-specific crisis intervention for pediatric providers co-developed by the PI (licensed psychologist) and autistic people, which was published in Pediatrics. Similar to the SPI, CIPP-A is delivered by providers to youth and their parents and focuses on teaching the family a series of crisis interventions to keep youth safe as they experience suicidal thoughts and/or behaviors, with autism-specific adaptations. Autism-specific adaptations include warning signs (e.g., sensory overload, social burnout) that may be unique to this population, as well as coping skills (e.g., quiet time alone in sensory friendly environment, engagement in preferred interests). The CIPP-A contains an overview of autism and how suicidal thoughts/behaviors may present differently in this population. The CIPP-A can be delivered by providers to families in person or virtually during clinic visits. Further, the CIPP-A is can be flexibly delivered by a variety of healthcare professionals.
Sponsors
Children's Hospital Los Angeles
Children's Hospital of Philadelphia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Pediatric providers will be randomized 1:1 to receive training in Safety Planning Intervention (SPI; control condition) or Crisis Interventions for Pediatric Providers - Autism version (CIPP-A)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Pediatric healthcare providers serving autistic youth in a DBP clinic in the U.S. * Willing and able to participate in the study and its activities, including remote training in either SPI or CIPP-A (depending on randomization) * Willing and able to provide informed consent * Comfortable speaking or communicating in English
Exclusion criteria
* Pediatric healthcare providers not serving autistic youth * Pediatric healthcare providers not practicing in a DBP clinic in the U.S. * Unwilling and unable to participate in the study and its activities * Unwilling and unable to provide informed consent * Not comfortable speaking or communicating in English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility: Number of times that providers use SPI or CIPP-A in 6 months | Baseline to 6 months | The feasibility of SPI and CIPP-A will be assessed by an online survey of the number of times that providers used SPI/CIPP-A with autistic patients in 6 months. The survey will be administered three times from baseline to 6 months. |
| Acceptability: Acceptability of Intervention Measure | Baseline to 6 months | The Acceptability of Intervention Measure (AIM) will be administered to providers to assess perceived acceptability of SPI and CIPP-A. The AIM is a widely used measure of the extent to which stakeholders believe an intervention is satisfactory in a given setting (e.g., "I like SPI"). The AIM items are scored on a 5-point scale (1, completely disagree to 5, completely agree), with higher scores indicating greater acceptability. The AIM will be administered three times from baseline to 6 months. |
| Initial Effectiveness: Providers confidence in using SPI or CIPP-A | Baseline to 6 months | A series of visual analog scales (VAS; 0-100%) will be used to measure changes in providers' confidence in managing patient crises over the study, with higher scores indicating higher confidence. The VAS will be administered three times from baseline to 6 months. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of Intervention Measure | Baseline to 6 months | A secondary outcome measure of the feasibility of SPI and CIPP-A will be assessed by the Feasibility of Intervention Measure (FIM), which assesses the extent to which stakeholders believe an intervention can be delivered in a given setting (e.g., "SPI seems easy to use"). The FIM items are scored on a 5-point scale (1, completely disagree to 5, completely agree), with higher scores indicating greater feasibility. The FIM will be administered three times from baseline to 6 months. |
| Fidelity of implementation | 6 months | A secondary outcome measure of the feasibility of SPI and CIPP-A will be assessed by a fidelity of implementation survey from providers about their adherence to SPI/CIPP-A components. The fidelity survey will be administered two times over 6 months. |
| Semi-structured interview to assess intervention feasibility | 6 months | A secondary outcome measure of the feasibility of SPI and CIPP-A will be assessed by a semi-structured interview to better understand providers' feasibility experiences (30-40 min). The interview will be administered once at 6 months. |
Countries
United States
Contacts
CONTACTJessica M Schwartzman, PhD
PRINCIPAL_INVESTIGATORJessica Schwartzman, PhD
Children's Hospital Los Angeles
Outcome results
None listed