A Pilot Evaluation of a Digital Peer Support Intervention for Suicidal Adolescents

Обзор

Suicide risk has increased among youth in underserved communities, where access to mental healthcare is limited. To address this need, the investigator team plans to evaluate the preliminary efficacy of a brief, low-cost, culturally responsive digital intervention for ethnically diverse youth at risk for suicide in The Bronx, New York. In collaboration with community stakeholders, suicide recovery narratives, featuring adolescents' experiences related to recovery from suicidal thoughts will be developed. A smartphone ecological momentary assessment (EMA) app will be used to evaluate whether a curriculum of these narratives provides anti-suicidal benefits to at-risk adolescents.

Подробное описание

This is a single-arm investigation of a novel suicide prevention intervention, called "Supporting Wellbeing with Everyday Experiences of Peers" (SWEEP). In a preliminary phase (Phase 1) of the study, suicide recovery narratives: short first-person stories about lived experience with and recovery from Bronx Adolescents will be collected. The investigator team will then evaluate evaluate the anti-suicidal benefits of this intervention in a single-arm trial. In a subsequent phase (Phase 2), adolescent participants (n=46) will be provided with the SWEEP intervention, which involves reading or listening to one suicide recovery narrative each day during the 14-day trial. Six of the 46 participants will be adolescents, with recent suicidal thoughts or depression, who are currently receiving mental healthcare in Montefiore's Outpatient Psychiatry Department, rather than those on the waitlist to receive these services. All six participants will then complete a post-intervention qualitative interview to inform potential changes to intervention procedures. During this second phase, suicide recovery narratives will be provided, in audio and text formats, via a smartphone app. That same smartphone app will also collect real-time (ecological momentary) assessments of suicidal thoughts, as well as secondary and additional outcomes, five times per day. The investigator team will evaluate whether participants experience reductions in the intensity of suicidal thoughts over the course of the 14-day trial. During Phase 3, participants will be recruited to a control condition (n=15) and a treatment condition (n=30). Those in the Phase 3 treatment condition will receive the same intervention (1 SWEEP narrative per day for 14 days + 3x/day EMA) as those in Phase 2. Those in the Control condition will receive 3x/day EMA only.

Вмешательства

• Поведенческое Supporting Wellbeing with Everyday Experiences of Peers (SWEEP)
  Each day during a 14-day trial period, participants will receive one narrative featuring lived experience with and recovery from suicidal thoughts and behaviors. These narratives will be presented in audio and text format via a smartphone app. Participants will also complete self-report surveys assessing study outcomes using the same smartphone app five times per day.

Первичные конечные точки

• Suicidal Thoughts [Срок оценки: 5 times per day during 14-day trial]

Вторичные конечные точки (5)

• Suicidal Urge Resistance [Срок оценки: 5 times per day during 14-day trial]
• Social Connectedness [Срок оценки: 5 times per day during 14-day trial]
• Optimism [Срок оценки: 5 times per day during 14-day trial]
• Social Support [Срок оценки: 5 times per day during 14-day trial]
• Intervention Acceptability [Срок оценки: Study conclusion (at the end of the 14-day trial)]

Критерии участия

Критерии включения

• past-month history of suicidal thoughts
• past-month history of Major depressive disorder
• possession of apple or android smartphone with data plan

Критерии исключения

• inability to read/write in English
• Active mania
• Active psychosis
• Autism spectrum disorder

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Не применимо

Модель

Одна группа

Маскирование

Открытое

Основная цель

Профилактика

Центры проведения

США · 1 центр

• Montefiore Health System — The Bronx

Публикации

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• Centers for Disease Control and Prevention. 10 leading causes of death, United States. WISQARS Fatal Injury Data Visualization Tool.
• Fox KR, Huang X, Guzman EM, Funsch KM, Cha CB, Ribeiro JD, Franklin JC. Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research. Psychol Bull. 2020 Dec;146(12):1117-1145. doi: 10.1037/bul0000305. Epub 2020 Oct 29. PMID 33119344
• Alvarez K, Polanco-Roman L, Samuel Breslow A, Molock S. Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems. Am J Psychiatry. 2022 Jun;179(6):422-433. doi: 10.1176/appi.ajp.21101001. PMID 35599542
• Bray MJC, Daneshvari NO, Radhakrishnan I, Cubbage J, Eagle M, Southall P, Nestadt PS. Racial Differences in Statewide Suicide Mortality Trends in Maryland During the Coronavirus Disease 2019 (COVID-19) Pandemic. JAMA Psychiatry. 2021 Apr 1;78(4):444-447. doi: 10.1001/jamapsychiatry.2020.3938. PMID 33325985
• Weimerskirch PJ. Benjamin Rush and John Minson Galt, II. Pioneers of bibliotherapy in America. Bull Med Libr Assoc. 1965 Oct;53(4):510-26. PMID 5319266
• Stip E, Ostlundh L, Abdel Aziz K. Bibliotherapy: Reading OVID During COVID. Front Psychiatry. 2020 Dec 7;11:567539. doi: 10.3389/fpsyt.2020.567539. eCollection 2020. PMID 33364987
• Evans K, Tyrer P, Catalan J, Schmidt U, Davidson K, Dent J, Tata P, Thornton S, Barber J, Thompson S. Manual-assisted cognitive-behaviour therapy (MACT): a randomized controlled trial of a brief intervention with bibliotherapy in the treatment of recurrent deliberate self-harm. Psychol Med. 1999 Jan;29(1):19-25. doi: 10.1017/s003329179800765x. PMID 10077290

Идентификаторы

NCT: NCT06349915 · 2023-15217

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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