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Signature Project

招牌项目

基本信息

批准号：
10487445
负责人：
GREGORY K BROWN
金额：
$ 112.21万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-15 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10487445
关键词：
Accident and Emergency department Adoption Ambulatory Care Caring Clinical Communities Consultations Counseling Credentialing Data Educational Intervention Effectiveness Emergency Care Emergency Department patient Emergency department visit Evaluation Evidence based intervention Evidence based practice Frequencies Future Health Care Costs Health Services Health system Hospitalization Individual Intervention Mediating Mediation Medicine Mental Health Mental Health Services Methodology Minority Groups Modeling Monitor Nature Outpatients Patient Care Patient Monitoring Patient-Focused Outcomes Patients Phase Prevention strategy Primary Health Care Randomized Research Research Design Research Personnel Resources Risk Safety Self Efficacy Services Site Suicide Suicide attempt Suicide prevention Telephone Time Training United States Department of Veterans Affairs Veterans Visit acute care base behavioral health collaborative care comparative effectiveness study compare effectiveness cost cost effective design disadvantaged population effectiveness evaluation evidence base follow-up health care settings high risk implementation evaluation implementation outcomes implementation research implementation science implementation trial improved innovation insight intervention delivery novel novel strategies outpatient programs preventive intervention provider factors reducing suicide research study satisfaction suicidal suicidal behavior suicidal patient suicidal risk telehealth treatment as usual

项目摘要

The Signature Project of the Penn Innovation in Suicide Prevention Implementation Research (INSPIRE) Center is a large-scale research study designed to examine the effectiveness and implementation of an evidence-based intervention to lower suicide risk in health care settings. The Project will leverage the methodological and administrative support of the INSPIRE Center with its focus on optimizing implementation of practice-based suicide prevention interventions for minority and disadvantaged populations. Individuals at high risk for suicide often present to acute care settings, such as emergency departments (EDs), and then typically are hospitalized or referred for outpatient mental health treatment. Yet, despite being at increased risk of suicidal behavior and suicide following an ED visit, many patients do not attend outpatient treatment. Brief evidenced-based interventions such as the Safety Planning Intervention and follow-up services (SPI+) are available to mitigate this risk and engage patients in outpatient treatment. However, such practices often can be challenging for busy ED clinicians to provide for suicidal patients. Our interdisciplinary team of suicide, implementation, health services, qualitative and quantitative researchers as well as diverse stakeholder groups of ED clinicians, health systems leaders, mental health clinicians, and patients will collaborate to improve the delivery of ED-based suicide prevention efforts. We propose a novel delivery model in which ED staff will connect patients at risk for suicide to mental health clinicians who are located external to the ED. These off-site licensed and credentialed clinicians will provide SPI+ via telehealth for ED patients prior to discharge and provide follow-up services after ED discharge as part of an innovative Suicide Prevention Consultation Center (SPCC). The Project has three Specific Aims. Aim 1 will use a stepped-wedge cluster-randomized design to evaluate the effectiveness of SPI+ delivered by SPCC clinicians via telehealth compared to SPI+ delivered by SPI+-trained ED clinicians on rates of suicidal behavior and engagement in care following ED discharge. Aim 2 will evaluate the implementation of SPI+ delivered by SPCC clinicians compared to SPI+ delivered by ED clinicians on key implementation outcomes including adoption, fidelity, acceptability, and feasibility and will also explore the mediation of clinician intentions, norms, and self-efficacy on the fidelity of SPI+. Aim 3 will evaluate the costs to ED and SPCC practices and examine potential cost offsets to the health system to provide evidence of SPCC scalability and sustainability. If successful and cost effective, use of a SPCC, external to EDs, could become a scalable model for providing suicide prevention evidenced-based practices to those at risk for suicide presenting for emergency care with the potential to save lives.

宾夕法尼亚大学自杀预防实施创新研究中心（INSPIRE）签名项目