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| Name | Class |
|---|---|
| Queen Mary Hospital, Hong Kong | OTHER |
| United Christian Hospital | OTHER |
| North District Hospital | OTHER |
| Pamela Youde Nethersole Eastern Hospital |
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The study will determine whether community-based caring contact via a mobile app connection with or without volunteer support in addition to treatment as usual (psychiatric and psychosocial treatments) has an effect on suicidal ideation and treatment compliance among post-discharge self-harm young adults.
The proposed study will determine whether community-based caring contact via a mobile app connection with or without volunteer support in addition to treatment as usual (TAU; psychiatric and psychosocial treatments) is effective in reducing suicidal ideation, enhancing treatment compliance, reducing thwarted belongingness and perceived burdensomeness and hopelessness among post-discharge self-harm young adults, and if personalized contact by volunteers has additional effects reducing suicidal ideation among post-discharge self-harm individuals.
108 participants aged 18-45 with an index self-harm episode will be recruited from the Accident & Emergency Department (AED) of 4 local public hospitals, and randomized into the TAU, mobile app group with, and without volunteer support. Each participant will complete a questionnaire at the 4 measurement time points at baseline (T0), one-month (T1) and the end of the 2-month intervention period (T2), and post-intervention at the three-month point (T3) from the baseline. The primary outcomes include Suicidal ideation, hopelessness, thwarted belongingness & perceived burdensomeness, treatment (TAU) compliance, and suicidality.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TAU w/ mobile app + volunteer support | Experimental | Participants will be receiving usual medical treatment from the hospitals with a mobile app engagement intervention, plus support from volunteers. |
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| TAU w/ mobile app engagement | Experimental | Participants will be receiving usual medical treatment from the hospitals with a mobile app engagement intervention. |
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| Treatment as Usual (TAU) | No Intervention | Participants will be receiving usual medical treatment from the hospitals, and without the interventions (i.e., mobile app and/or volunteer support) introduced through this randomized control trial. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Volunteer support | Behavioral | Each participant will be matched with a pair of trained volunteers (under pre-determined safety measures), who will initiate caring contact via telephone or text messages at least twice a month for two months. Participants will be free to respond or not. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline Adult Suicidal Ideation at 1-month, 2-month and 3-month | Change in scores on Suicidal ideation as measured by the self-report the Adult Suicidal Ideation Questionnaire - the four-item short form in Chinese (ASIQ-4) (Fu, Liu, & Yip, 2007) | Baseline, 1 month, 2 months, 3 months |
| Change from baseline Measurement of Hopelessness at 1-month, 2-month and 3-month | Change in scores on Hopelessness as measured by a self-report 4-item short-form of Beck Hopelessness Scale Chinese version (BHS-4) (Beck, Weissman, Lester, & Trexler, 1974; Yip & Cheung, 2006; Shek, 1993). | Baseline, 1 month, 2 months, 3 months |
| Change from baseline Interpersonal Needs at 1-month, 2-month and 3-month | Change in scores on Thwarted Belongingness (TB) and Perceived Burdensomeness (PB) as measured by the Interpersonal Needs Questionnaire (INQ-15), a 15-item measure of beliefs about whether one's need to belong is met or unmet and self-perceptions of being a burden to others (Van Orden, 2012). | Baseline, 1 month, 2 months, 3 months |
| Change from baseline Service Utilization at 1-month, 2-month and 3-month | Self-reported compliance with prescribed treatment (frequency) in relation to the index self-harm episode, including psychiatric follow-up care (e.g., medication, out-patient follow-up treatment, and community psychiatric nursing service) and psycho-social services (e.g., clinical psychology service, medical social work service, etc.) as measured by a self-developed service utilization checklist. | Baseline, 1 month, 2 months, 3 months |
| Change from baseline Suicidality at 1-month, 2-month and 3-month | Suicidality as measured by a four-item scale for levels of suicidality in the past 12 months (Centre for Suicide Research and Prevention, The University of Hong Kong, 2005) |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline Depressive state at 1-month, 2-month and 3-month | Depressive state as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) (Lam et al., 2004). | Baseline, 1 month, 2 months, 3 months |
| Change from baseline Self-harming repetition at 1-month, 2-month and 3-month |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Frances LAW, PhD | Contact | +852-3917-5940 | flawhk@hku.hk |
| Name | Affiliation | Role |
|---|---|---|
| Yik-wa Law, PhD | The University of Hong Kong | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pamele Youde Nethersole Eastern Hospital | Recruiting | Chai Wan | Eastern District | 852 | Hong Kong | |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27278570 | Background | Law YW, Yip PS, Lai CC, Kwok CL, Wong PW, Liu KS, Ng PW, Liao CW, Wong TW. A Pilot Study on the Efficacy of Volunteer Mentorship for Young Adults With Self-Harm Behaviors Using a Quasi-Experimental Design. Crisis. 2016 Nov;37(6):415-426. doi: 10.1027/0227-5910/a000393. Epub 2016 Jun 9. | |
| 22846445 | Background |
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| ID | Term |
|---|---|
| D016728 | Self-Injurious Behavior |
| D013405 | Suicide |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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| OTHER |
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| Mobile app | Other | Participants will receive programmed care messages and reminders of community resources and healthcare contacts on a regular basis. The app will also provide simple self-help mood checking and relaxation exercises. |
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| Baseline, 1 month, 2 months, 3 months |
Self-reported frequency of self-harm repetition (retrieved from the Hong Kong Special Administrative Region (HKSAR) Coroner's Court) |
| Baseline, 1 month, 2 months, 3 months |
| Change from baseline suicide deaths at 1-month, 2-month and 3-month | Number of suicide deaths (retrieved from the Hong Kong Special Administrative Region (HKSAR) Coroner's Court) | Baseline, 1 month, 2 months, 3 months |
| Change of baseline index self-harm episode | Hospital records on the details of index self-harm episode including clinical diagnosis, treatment received, discharged information and number of Accident & Emergency Department (AED) re-admissions, etc. in Clinical Management System (CMS), Outpatient Appointment System (OPAS), and Accident & Emergency Department Clinical Information System (AEIS) | Baseline, 1 month, 2 months, 3 months |
| Demographic and socioeconomic information | Questionnaire on participants' demographic and socioeconomic information (e.g. Sex, Date of birth, birth place, years living in Hong Kong, Marital status, religion, residential district, education, living status, employment, occupation, social security, etc. | Baseline |
| Change of time spent on each programme activity of the app at 1-months, 2-months | The log-in time-stamp of each activity (including but not limited to reviewing the information or messages provided on the app, pattern of using the app, etc.) | From Baseline to 2 months |
| Change of time spent and type of contact made by volunteers with participants at 1-months, 2-months | Volunteer service records on time-stamp of each type of contact (i.e. in-person, phone contact, letters & email, and social media) | 1-month, 2-months |
| Final and Monthly Qualitative Description on participants' progress | Reported by volunteers. items included case summary, services offered, volunteer-participant relationship, follow-up plan, self-reflection and areas of improvement, etc. | up to 3 months |
| United Christian Hospital |
| Recruiting |
| Sau Mau Ping |
| Kwun Tong District |
| 852 |
| Hong Kong |
| North District Hospital | Recruiting | Sheung Shui | North District | 852 | Hong Kong |
| Queen Mary Hospital | Recruiting | Central | Southern District | 852 | Hong Kong |
| Luxton DD, June JD, Comtois KA. Can postdischarge follow-up contacts prevent suicide and suicidal behavior? A review of the evidence. Crisis. 2013 Jan 1;34(1):32-41. doi: 10.1027/0227-5910/a000158. |
| 21928908 | Background | Van Orden KA, Cukrowicz KC, Witte TK, Joiner TE. Thwarted belongingness and perceived burdensomeness: construct validity and psychometric properties of the Interpersonal Needs Questionnaire. Psychol Assess. 2012 Mar;24(1):197-215. doi: 10.1037/a0025358. Epub 2011 Sep 19. |
| 37585260 | Derived | Law YW, Lok RHT, Chiang B, Lai CCS, Tsui SHM, Chung PYJ, Leung SC. Effects of Community-Based Caring Contact in Reducing Thwarted Belongingness Among Postdischarge Young Adults With Self-Harm: Randomized Controlled Trial. JMIR Form Res. 2023 Aug 16;7:e43526. doi: 10.2196/43526. |
| 33884617 | Derived | Witt KG, Hetrick SE, Rajaram G, Hazell P, Taylor Salisbury TL, Townsend E, Hawton K. Psychosocial interventions for self-harm in adults. Cochrane Database Syst Rev. 2021 Apr 22;4(4):CD013668. doi: 10.1002/14651858.CD013668.pub2. |