Adapting a Brief Suicide Intervention for Pediatric Primary Care: Enhancing Uptake and Impact
Overview
- Phase
- Not Applicable
- Intervention
- Treatment as Usual
- Conditions
- Suicide Prevention
- Sponsor
- University of Washington
- Enrollment
- 48
- Primary Endpoint
- Intervention Appropriateness Measure
- Status
- Not yet recruiting
- Last Updated
- 12 days ago
Overview
Brief Summary
Suicide is a leading cause of death among adolescents in the United States and improving access to high quality just-in-time suicide interventions to reduce risk has important public health implications. Integrating such interventions into routinely accessed settings, such as pediatric primary care, holds promise; however, many clinicians in these settings fail to adequately screen or intervene in youth suicidal thoughts and behaviors, representing a key barrier to reducing suicide. The proposed study is a pre-post quasi-experimental pilot feasibility and preliminary efficacy trial of a suicide prevention intervention informed by evidence based interventions including the SAFETY-Acute suicide prevention intervention implemented in 3 pediatric primary care clinics.
Detailed Description
This project aims to take an innovative, user-centered design approach to improve suicide prevention in primary care settings to support primary care management of adolescents with low to moderate risk suicidal thoughts and behaviors (STB), drawing on the evidence-based SAFETY-Acute (SAFETY-A; formerly known as Family Intervention for Suicide Prevention -aka FISP) intervention. In this trial, the investigators will conduct a pre-post quasi-experimental pilot feasibility and preliminary efficacy study of an adapted STB model of care compared to treatment as usual, with 3 primary care clinics. The trial will include 48 10-18-year-old patients with STB and their parents/caregivers. The investigators will assess acceptability and feasibility of the STB model of care, preliminary intervention impacts, and need for further adaptation.
Investigators
Sarah Danzo
Assistant Professor, Department of Psychiatry and Behavioral Sciences
University of Washington
Eligibility Criteria
Inclusion Criteria
- •Adolescent Inclusion Criteria:
- •adolescent between the ages of 10 and 18 years old
- •speaks fluent English
- •current or past low to moderate suicide risk (denies current plan with intent to kill self)
Exclusion Criteria
- •high suicide risk (endorses current plan and intent)
- •does not speak fluent English
- •does not have a primary care provider
- •Caregiver Inclusion Criteria:
- •has a child who meets inclusion criteria
- •Age 18 years or older
- •Caregiver Exclusion Criteria:
- •does not have a child who meets inclusion criteria
- •does not speak English
- •Provider Inclusion Criteria:
Arms & Interventions
Treatment as usual
Arm 1 entails months 1-2 of this study. Treatment as usual will be delivered by providers to adolescent patients in their clinics during the first two months of this study. Treatment as usual will be defined by each individual clinic based on their existing clinic protocols.
Intervention: Treatment as Usual
Pilot Intervention
Arm 2 entails months 3-4 of this study. Participating providers will deliver the adapted pilot intervention for the second half (months 3-4) of the pilot trial. The intervention will be based on the evidence-based suicide prevention interventions including the SAFETY-Acute protocol and will be adapted based on information from potential users prior to piloting. It is anticipated that both adolescent patients and their parents/caregivers will be involved in the intervention. Anticipated components of the intervention include psychoeducation, coping skills, safety planning, lethal means restriction, parenting skills, communication skills, identifying adolescent and family strengths, and linking to longer term care.
Intervention: Pilot Intervention
Outcomes
Primary Outcomes
Intervention Appropriateness Measure
Time Frame: Participant and providers complete approximately 2 weeks after completing intervention
Participant rated appropriateness of the intervention (includes 4 items scored on a 5 point likert scale with higher scores representing greater appropriateness.)
Feasibility of Intervention Measure
Time Frame: Participant and providers complete approximately 2 weeks after completing intervention
Feasibility of the intervention (includes 4 items scored on a 5 point likert scale with higher scores representing greater feasibility.)
Intervention Usability Scale
Time Frame: Participant/provider completes approximately 2 weeks after completing intervention
Participant rated intervention usability (includes 10 items scored on a 5 point likert scale with greater total score representing greater usability).
Acceptability of Intervention Measure
Time Frame: Participant and providers complete approximately 2 weeks after completing intervention
Participant rated acceptability of the intervention (includes 4 items scored on a 5 point likert scale with higher scores representing greater acceptability.)
Youth Satisfaction Questionnaire
Time Frame: Participant completes approximately 2 weeks after completing intervention
Adolescent participant rated satisfaction with the intervention (includes 5 items scored on a 3 point likert scale with higher scores representing greater satisfaction.)
Client Satisfaction Questionnaire
Time Frame: Participant completes approximately 2 weeks after completing intervention
Participant rated satisfaction with the intervention (includes 8 items scored on a 4 point likert scale with higher scores representing greater satisfaction.)
Secondary Outcomes
- Parent Self Efficacy Scale(Participant completes at baseline, approximately 2 weeks after completing intervention, and again 2 months following the intervention)
- Adapted General Self-Efficacy Scale(Participant completes at baseline, approximately 2 weeks after completing intervention, and again 2 months following the intervention)
- adapted Child Parent Relationship Scale(Participant completes at baseline, approximately 2 weeks after completing intervention, and again 2 months following the intervention)
- Adult Child Relationship Scale (ACRS)/Child Parent Relationship Scale (CPRS)(Participant completes at baseline, approximately 2 weeks after completing intervention, and again 2 months following the intervention)