Men and Providers Preventing Suicide (MAPS)

Not Applicable

Completed

• Conditions: Suicidal Ideation; Suicidal Intention; Suicide, Attempted
• Interventions: Behavioral: MAPS tailored multimedia patient activation program; Behavioral: Sleep hygiene video; Behavioral: Telephone evidence-based follow-up care; Behavioral: Commitment to Living for Primary Care

• Registration Number: NCT02986113
• Lead Sponsor: University of California, Davis

Brief Summary

This study will determine if suicidal middle-aged men who use a personalized computer program addressing suicide risk before a primary care visit are more likely to discuss suicide and accept treatment, reducing their suicide preparatory behaviors and thoughts.This is important because half of all men who die by suicide visit primary care within a month of death, yet few broach the topic, missing chances for prevention.

Detailed Description

In this study, the investigators will enroll middle-aged men with active suicide thoughts in a randomized controlled trial (RCT) to examine whether their use of the Men and Providers Preventing Suicide (MAPS) tailored interactive multimedia patient activation program immediately before a primary care provider (PCP) visit, linked with integrated telephone evidence-based follow-up care (TEBFC) (vs. attention control exposure linked with TEBFC), reduces suicide preparatory behaviors and ideation over 3 months. About half of all middle-aged men who die by suicide are seen by a PCP within a month of dying, suggesting the value of primary care-based suicide prevention efforts, to complement strategies in other settings. Current impediments to primary care-based prevention are that many suicidal middle-aged men do not visit a PCP, and among those who do the topic of suicide is rarely broached, due to societal gender-linked norms (e.g., toughness); stigma; spurious concerns that talking about suicide increases risk; competing time demands; and lack of resources to cope with positive responses. PCP-targeted educational interventions have increased detection of suicidal men, but have inconsistently affected suicide behaviors, and still many suicidal men went undetected. Suicide behaviors are more likely to be reduced by evidence-based follow-up care - supportive follow-up contact and collaborative mental health care. However, such care can only be effective if at-risk men visit a PCP who identifies suicide risk and offers the care, and the men accept it. Thus, there is a pressing need to study the use of innovative tools like MAPS to activate at risk middle-aged men to signal their receptiveness to suicide discussion and care, prompting PCP inquiry and referrals to a form of follow-up care that is feasible for most practices to implement (e.g., TEBFC).

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study Start: 2016-12
• Study First Submitted: 2016-12-02
• Study First Submitted QC: 2016-12-07
• Study First Posted: 2016-12-08
• Primary Completion: 2019-07
• Study Completion: 2019-09
• Status Verified: 2019-10
• Last Update Submitted: 2019-10-28
• Last Update Posted: 2019-10-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Male
• Target Recruitment: 93

Inclusion Criteria

• Self-identified male gender
• Aged 35-74
• Has a PCP at a primary care office in one of the two participating health systems who is actively enrolled in the RCT
• Active suicide thoughts within past 4 weeks
• Able to read and speak English; and self-reported adequate vision, hearing, and hand function to engage with an interactive computer program on a touchscreen electronic tablet device.

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Exclusion Criteria

• Reported or apparent highly unstable medical status (e.g. acute decompensated heart failure requiring immediate care)
• Reported or apparent highly unstable mental health status (e.g. acute uncontrolled psychosis)
• Presence of terminal illness with death anticipated within 3 months
• Plan to leave the current primary care office (e.g., transfer care) within 3 months
• Incarcerated
• Inability to understand and/or provide informed consent, following appropriate explanation

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Men and Providers Preventing Suicide	MAPS tailored multimedia patient activation program	Tailored interactive multimedia intervention, aimed at activating suicidal middle-aged men to disclose and discuss their suicide thoughts with and be receptive to treatment offers from a primary care provider during a linked office visit
Sleep hygiene video	Sleep hygiene video	A brief (3 minute) video regarding sleep hygiene, accompanied by introductory text summarizing research linking sleep problems with increased suicide risk.
Sleep hygiene video	Telephone evidence-based follow-up care	A brief (3 minute) video regarding sleep hygiene, accompanied by introductory text summarizing research linking sleep problems with increased suicide risk.
Sleep hygiene video	Commitment to Living for Primary Care	A brief (3 minute) video regarding sleep hygiene, accompanied by introductory text summarizing research linking sleep problems with increased suicide risk.
Men and Providers Preventing Suicide	Telephone evidence-based follow-up care	Tailored interactive multimedia intervention, aimed at activating suicidal middle-aged men to disclose and discuss their suicide thoughts with and be receptive to treatment offers from a primary care provider during a linked office visit
Men and Providers Preventing Suicide	Commitment to Living for Primary Care	Tailored interactive multimedia intervention, aimed at activating suicidal middle-aged men to disclose and discuss their suicide thoughts with and be receptive to treatment offers from a primary care provider during a linked office visit

Primary Outcome Measures

Name	Time	Method
Patient: Beck Scale for Suicide Ideation	3 months

Secondary Outcome Measures

Name	Time	Method
Patient: Reported discussion of suicide during study visits	Immediately post-study visit
Patient: suicidal intent scale	3 months
Patient adherence to telephone evidence-based follow-up care, ascertained from care manager patient contact logs	1 month, 2 months, 3 months
Patient: enrollment in telephone evidence-based follow-up care	Immediately post-study visit, 1 month, 2 months, 3 months
Patient: perceptions of the study interventions and trial participation questionnaire	3 months
Patient: Interpersonal Needs Questionnaire	1 month, 2 months, 3 months	Perceived burdensomeness and belongingness to others
Patient: augmented Patient Health Questionnaire (PHQ-9)	1 month, 2 months, 3 months	PHQ-9 plus six "male depression" items
Patient: Short Form-12 health survey (SF-12) Mental Component Summary score	1 month, 2 months, 3 months	Mental health status
Patient: Toughness scale	1 month, 2 months, 3 months	Gender-linked views regarding health-related help-seeking
Patient: SF-12 Physical Component Summary score	1 month, 2 months, 3 months	Physical health status
PCP: perceptions of baseline training videos questionnaire	Immediately after completing the video training	Measured by questionnaire
PCP: reported discussion of suicide during study visits	Immediately post-study visit
PCP: The number of times that PCPs refer study patients to TEBFC, ascertained from study care manager logs	Through study completion, up to 3 years
PCP: attitudes toward caring for suicidal patients questionnaire	At study completion, up to 3 years
PCP: perceptions of study participation questionnaire	At study completion, up to 3 years

Trial Locations

Locations (2)

University of California Davis Health System; 🇺🇸 Sacramento, California, United States

Palo Alto Medical Foundation Research Institute; 🇺🇸 Palo Alto, California, United States