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Practice Experiences for School Reintegration

Not Applicable
Completed
Conditions
Suicide
Registration Number
NCT05934396
Lead Sponsor
University of North Carolina, Chapel Hill
Brief Summary

This study is developing and refining a novel Virtual Reality (VR) supplement for inpatient treatment: the Practice Experiences for School Reintegration (PrESR) program. The PrESR will provide immersive school experiences for inpatient adolescents (with suicidal-related admissions) to practice skills in real-world settings with the guidance of a trained clinician within the confines of a hospital. This pilot study follows a Multiphase Optimization Strategy (MOST) to conduct a pilot optimization trial of the PrESR to inform the feasibility of training clinicians, the ability to recruit adolescent inpatient participants, and management of experimental conditions. This study is not powered to test hypotheses; however, in addition to assessing feasibility and acceptability, this pilot trial will assess candidate intermediary and outcome measures.

Detailed Description

This study follows a multiphased optimization (MOST) research design; this clinical trial is considered to be a pilot optimization component of the MOST framework. For the present study, a prospective sample of adolescents hospitalized for suicidal thoughts and behaviors will be randomly selected into one of 8 experimental conditions (N=5-6 per group). Although the intervention for the pilot optimization trial will be implemented by a member of research staff, this study will also aim to recruit 2-5 clinicians to deliver the full intervention to a separate sample of adolescent patients to inform acceptability and feasibility of the intervention within their clinical workflow.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
54
Inclusion Criteria

Adolescent Participants:

  • current hospitalization for suicidal thoughts and behaviors
  • ages 13-18
  • expected return to school following discharge
  • ability to speak, read, and understand English sufficiently to complete study procedures,
  • consent of a parent/legal guardian (in English or Spanish; for minor participants)
  • adolescent assent or consent (in English)
  • clinician approval.

Hospital professionals:

  • Works as a clinician at the hospital site who delivers treatment including CBT to hospitalized adolescents,
  • Hospital professional consent (in English)
  • consent of patient's parent/legal guardian (in English or Spanish; for minor participants)
  • adolescent patient assent or consent (in English).
Exclusion Criteria

Adolescent Participants

  • evidence of active psychosis,
  • evidence of intellectual disability
  • Risk for Cyber-sickness (greater than or equal to 50th percentile as measured on the Motion Sickness Susceptibility Questionnaire)

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Primary Outcome Measures
NameTimeMethod
Average Number of Minutes to Complete Each Intervention SessionBaseline

Time to complete intervention sessions, each session is expected to last less than 60 minutes. Average calculated by summing all sessions in each condition and dividing by total number of sessions. Note that the number of participants to start a Period is not equal to the number who completed previous Period for "Affect Regulation + Problem Solving" and "Cognitive Restructuring + Problem Solving" because 1 participant in each condition was withdrawn or withdrew.

Proportion of Patients in the Target Population Who Agree to ParticipateBaseline

Recruitment rate was determined based on the proportion of adolescents providing assent and parents or legal guardians providing permission relative to the number of parents or legal guardians approached.

Proportion of Patients in the Target Population Excluded Due to Motion Sickness ScreeningBaseline

Rate of recruitment related to motion sickness was determined based on the proportion of assented adolescents whose scores were \>/= than 50th percentile on motion sickness questionnaire relative to the number of assented adolescents.

Proportion of Participants Who Complete All Study Proceduresup to 3-months following school re-entry

Proportion of participants who complete all study procedures was determined based on the proportion of adolescents completing study procedures at Baseline, 2-week follow-up, 3-month follow-up, and journals over the two weeks of their return to school relative to the total number of adolescents participating in that condition.

Average Number of Hours to Complete Assessments at Each Time Pointup to 3-months following school re-entry

Time to complete assessments, assessments are expected to last less than 4 hours. Note that the number of participants to start a Period is not equal to the number who completed previous Period for "Affect Regulation + Problem Solving" and "Cognitive Restructuring + Problem Solving" because 1 participant in each condition was withdrawn or withdrew.

Percentage of Adolescent Participants in Which Intervention Delivered With Greater Than or Equal to 80% FidelityBaseline

Percentage of participants in which adherence to delivery of key components of intervention (i.e., skill lessons or practice sessions) across sessions in each condition was 80% or greater. Adherence was calculated based on the number of key components completed relative to the total number of key components expected to be completed for each participant. Note that the number of participants to start a Period is not equal to the number who completed previous Period for "Affect Regulation + Problem Solving" and "Cognitive Restructuring + Problem Solving" because 1 participant in each condition was withdrawn or withdrew.

Percentage of Adolescent Participants With Average Acceptability Scores Less Than or Equal to 2Baseline

Percent of adolescents with average acceptability score less than or equal to 2 (or "agree") on a five-point scale from 1 (strongly agree) to 5 (strongly disagree). Note that the number of participants to start a Period is not equal to the number who completed previous Period for "Affect Regulation + Problem Solving" and "Cognitive Restructuring + Problem Solving" because 1 participant in each condition was withdrawn or withdrew, and due to missing post-baseline data for "Problem Solving" (1 participant), "Cognitive Restructuring" (1 participant), "Affect Regulation + Cognitive Restructuring" (1 participant), "Cognitive Restructuring + Problem Solving" (1 participant), and "Affect Regulation + Cognitive Restructuring + Problem Solving" (1 participant).

Percentage of Hospital Professional Participants With Average Acceptability Scores Less Than or Equal to 2Baseline

Percent of hospital professionals with average acceptability score less than or equal to 2 (or "agree") on a five-point scale from 1 (strongly agree) to 5 (strongly disagree). Note that the number of participants to start a Period is not equal to the number who completed previous Period for Hospital Professionals because 7 professionals consented into the study, but only 4 delivered the intervention to a patient following consent.

Hospital Professionals' Perceptions of AcceptabilityBaseline

Qualitative feedback provided by Hospital Professionals delivering the intervention to one or more hospitalized adolescents about acceptability of the intervention. Note that the number of participants to start a Period is not equal to the number who completed previous Period for Hospital Professionals because 7 professionals consented into the study, but only 4 delivered the intervention to a patient following consent.

Adolescents' Perceptions of AcceptabilityBaseline

Qualitative feedback provided by adolescents receiving the intervention in the Optimization Trial about acceptability of the intervention. Note that the number of participants to start a Period is not equal to the number who completed previous Period for "Affect Regulation + Problem Solving" and "Cognitive Restructuring + Problem Solving" because 1 participant in each condition was withdrawn or withdrew, and due to missing post-baseline data for "Cognitive Restructuring + Problem Solving" (1 participant).

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

UNC Adolescent Psychiatry Inpatient Unit

🇺🇸

Chapel Hill, North Carolina, United States

UNC Adolescent Psychiatry Inpatient Unit
🇺🇸Chapel Hill, North Carolina, United States

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