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| Name | Class |
|---|---|
| Patient-Centered Outcomes Research Institute | OTHER |
| Idaho Crisis & Suicide Hotline | OTHER |
| University of Washington | OTHER |
| Columbia University |
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Randomized controlled trial to determine the best brief suicide prevention intervention for adults and adolescents who screen positive for suicidal ideation or behavior in emergency departments or primary care clinics.
Aim 1: Compare the effectiveness of two brief suicide prevention interventions (safety planning intervention plus structured phone-based follow-up from a suicide prevention hotline (SPI+), versus safety planning intervention plus caring contacts (CC)) to (a) reduce suicidal ideation and behavior, (b) reduce loneliness, (c) reduce return to care for suicidality, and (d) increase uptake of outpatient mental healthcare services over 12 months among adult and adolescent patients screening positive for suicide in emergency departments (EDs) and primary care clinics.
Aim 2: Assess the acceptability of connection and support planning and the safety planning intervention, with or without follow-up among providers and clinical staff in EDs and primary care clinics.
Aim 3: Assess the acceptability of SPI+ and SP+CC among adult and adolescent patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SPI+: Safety Planning Intervention plus structured phone-based follow-up | Experimental | The Safety Planning Intervention (SPI+) includes safety planning (moderate or high risk for suicide) or connection & support planning (low risk for suicide) at the clinic or ED, plus a structured telephone-based intervention from a suicide prevention hotline |
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| Caring Contacts: Safety Planning Intervention plus Caring Contacts (SP+CC) | Experimental | SP+CC will include safety planning (moderate or high risk for suicide) or connection & support planning (low risk for suicide) at the clinic or ED, plus caring text messages or emails from a suicide prevention hotline. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SPI+ | Behavioral | Suicide prevention hotline follow-up specialists will call participants to (1) conduct a brief suicide risk assessment; (2) review and discuss the participant's connection and support plan or safety plan; and (3) provide referrals to social services or other support with treatment engagement, if indicated. Participants will receive at least one and optional additional phone calls, generally delivered according to the following schedule: days 3, 7, 14, 30, 60, 90. Modifications may be made to the schedule due to weekends, holidays, or participant availability, and additional calls may be scheduled as desired by the participant. The follow-up will stop once the participant is successfully engaged in outpatient treatment or does not desire further follow-up support. |
| Measure | Description | Time Frame |
|---|---|---|
| Suicidal Ideation & Behavior; measured using the Columbia Suicide Severity Rating Scale (C-SSRS) since-last-contact screener (self-assessment) | 6-item questionnaire with yes/no response options. Scores range from 0 (no risk) to 6 (high risk) | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Loneliness; measured using the NIH Toolbox Emotion Batteries Loneliness Scale | 5-item questionnaire with Likert scale response options (1=never, 5=always). Scores range from 5 (no loneliness) to 25 (high levels of loneliness). | 6 months |
| Loneliness; measured using the NIH Toolbox Emotion Batteries Loneliness Scale |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anna K Radin, DrPH, MPH | St. Luke's Health System | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St. Luke's Health System | Boise | Idaho | 83712 | United States |
After publication of the final research report, de-identified data may be shared with other researchers.
Data are estimated to become available in 2026.
A data access committee will review and make decisions on all requests to access data.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Apr 22, 2021 | Apr 28, 2021 |
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| OTHER |
| University of Pennsylvania | OTHER |
Individual-level randomization to one of two treatment arms
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| SP+CC (Caring Contacts) | Behavioral | SP+CC follow-up includes one phone conversation with a suicide prevention hotline follow-up specialist and a series of personalized caring messages sent over the course of 12 months via text or email (based on participant preference). Caring contacts will generally be sent according to the following schedule: 3 in the first week, 6 weekly, 6 bi-weekly, 4 monthly; 2 bi-monthly, and one each for the participant's birthday, Thanksgiving, Christmas, and New Year's (total of 25 over 12 months). Slight variation in the schedule is allowed. There is no expectation that participants respond to the text messages; if they do, follow-up specialists reply to any incoming texts. Replies are individually-tailored and caring. |
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5-item questionnaire with Likert scale response options (1=never, 5=always). Scores range from 5 (no loneliness) to 25 (high levels of loneliness). |
| 12 months |
| Utilization of Emergency Department for Suicidality | Measured through self-report | 6 months |
| Utilization of Emergency Department for Suicidality | Measured through self-report | 12 months |
| Attendance at Outpatient Behavioral Health Appointments | Measured through self-report | 6 months |
| Attendance at Outpatient Behavioral Health Appointments | Measured through self-report | 12 months |
| Suicidal Ideation & Behavior; measured using the Columbia Suicide Severity Rating Scale (C-SSRS) since-last-contact screener (self-assessment) | 6-item questionnaire with yes/no response options. Scores range from 0 (no risk) to 6 (high risk) | 12 months |
| Prot_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Apr 23, 2021 | Apr 28, 2021 | ICF_001.pdf |
| ID | Term |
|---|---|
| D013405 | Suicide |
| D013406 | Suicide, Attempted |
| D059020 | Suicidal Ideation |
| D000092862 | Psychological Well-Being |
| D001523 | Mental Disorders |
| D004630 | Emergencies |
| D003866 | Depressive Disorder |
| D003863 | Depression |
| D000092864 | Suicide Prevention |
| ID | Term |
|---|---|
| D016728 | Self-Injurious Behavior |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D010549 | Personal Satisfaction |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019964 | Mood Disorders |
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