An Adaptive Intervention to Increase Engagement to Community-Based Care After an ED Admission

Not Applicable

Recruiting

• Conditions: Suicidal and Self-injurious Behavior; Linkage to Care

• Registration Number: NCT07092345
• Lead Sponsor: Rhode Island Hospital

Brief Summary

The goal of this study is to develop a feasible brief, family-based adaptive intervention, via SMART design, for youth with suicidal and non-suicidal self-injurious behavior (SSIB) to increase community-based mental health (MH) care attendance and reduce SSIB risk post emergency department (ED) admission. The intervention will focus to increase understanding on youth MH literacy, MH communication, and MH engagement. Integrating an adaptive intervention via a SMART design in the ED could address subsequent barriers to youth obtaining appropriate level of community-based MH care and therefore reduce ED readmissions.

Detailed Description

This adaptive intervention allows for two stages of randomization to address treatment non-response. First, youth and caregivers (dyads) will be randomized to receive 1st-stage interventions in the ED, either the digital psychosocial-only condition or the psychosocial with digital health communication via text messages condition. If after two weeks, youth are identified as non-response, then dyads will be re-randomized to 2nd-stage intervention(s) that will include the use of a family navigation model.

Study Timeline

• Study Start: 2025-03-17
• Study First Submitted: 2025-03-17
• Status Verified: 2025-07
• Study First Submitted QC: 2025-07-22
• Last Update Submitted: 2025-07-22
• Study First Posted: 2025-07-29
• Last Update Posted: 2025-07-29
• Primary Completion: 2029-01
• Study Completion: 2029-03-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 186

Inclusion Criteria

• Youth 8 to 17 years
• Youth presenting to the ED with suicide and self-injurious behavior
• Youth living at home with at least one legal guardian/caregiver

Exclusion Criteria

• Youth presenting to the ED with psychosis, sexual assault, child abuse
• Youth in police custody,
• Youth with an active investigation with the department of child and youth services (DCYF)
• Youth unable to assent due to severity of illness or developmental disabilities,
• Youth who cannot communicate in English or Spanish,
• Youth without a caregiver/legal guardian who can provide consent

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Primary Outcome Measures

Name	Time	Method
Intervention Feasibility	3-month & 6-month follow-up assessments	Recruitment rate (% of ppl who agree to be in the study), Study completion (% of ppl who complete entire study)
Child and Adolescent Service Assessment (CASA)	3-month and 6-month follow-up assessments	Youth Attendance to Community-based Mental Health Care. CASA question and caregiver report of youth attendance in behavioral health care/community-based mental health services (yes or no) after discharge from emergency department admission.
Intervention Acceptability	3-month and 6-month follow-up assessments	Client Satisfaction Questionnaire. An 8-item questionnaire that provides (positive \& negative) feedback from user opinion. Higher scores = greater satisfaction with intervention.

Trial Locations

Locations (1)

Hasbro Children's Hospital; 🇺🇸 Providence, Rhode Island, United States