CAMS Relational Agent System (CAMS-RAS) for Suicide Prevention

项目摘要 在美国，每年有超过44，000人死于自杀，使自杀成为第十大自杀原因。 死亡的原因和10 - 44中的第二大死亡原因。此外，980万 成年人每年都有自杀的念头，有100万人企图自杀。从2006年到2013年， 成年人中因自杀意念就诊的艾德平均每年增加12%。虽然数百万人 每年致力于防止自杀，自杀率在美国上升。我们的最终目标是减少死亡人数， 自杀，同时也减少了不必要的住院、急诊（艾德）和住院 重新入院，并通过使用创新技术停止急性危机护理的旋转门。 在第一阶段，我们提出：（1）开发并科学验证一个虚拟形象，供自杀艾德患者使用 提供自杀的合作评估和管理（CAMS），一个有效的， 大卫乔布斯博士开发的成本效益干预;（2）设计临床支持工具和 艾德医疗服务提供者使用时间培训，以加强其基于证据的自杀协议的交付 并促进以证据为基础的出院处置方法。我们的工作也以第一阶段为指导， 评论家的担忧我们完全达到并超越了项目目标。最值得注意的是，我们创造了一个15分钟的化身， （"戴夫博士"）谁执行了CAMS自杀状态访谈的一部分，这是很受欢迎的， 被自杀的艾德患者描述为与"戴夫医生"互动的帮助。 在第二阶段，我们建议完成虚拟CAMS患者和提供者工具的开发， 为EHR集成到EPIC做好准备。我们将再次使用敏捷开发过程并寻求反馈 目标最终用户。一个多元化的顾问团队将向我们咨询，以确保产品的卓越性， 为商业化做准备。为了确保对产品的提供者和患者工具进行彻底测试，我们将 使用两种条件的随机研究来评估Virtual CAMS在预防自杀行为方面的有效性， 不适当/不必要的住院，并提高自我效能，以应对急性痛苦。

PROJECT ABSTRACT Over 44,000 people die annually by suicide in the United States (US) making suicide the 10th leading cause of death overall and the second leading cause of death among those 10-44. In addition, 9.8 million adults contemplate suicide annually, and one million will make a suicide attempt. From 2006 to 2013, the rate of ED visits for suicidal ideation among adults increased by 12% on average annually. While millions are devoted annually to prevent suicide, suicide rates are rising in the US. Our ultimate aim is to reduce deaths by suicide while also reducing unnecessary hospitalization, emergency department (ED) and hospital readmissions, and stop the revolving-door of acute crisis care through the use of innovative technologies. In Phase I, we proposed to: (1) develop and scientifically validate an avatar for use by suicidal ED patients that delivers the Collaborative Assessment and Management of Suicidality (CAMS), an efficacious and cost-effective intervention developed by David Jobes, PhD; and (2) to design clinical support tools and Just-in- Time training for use by ED medical providers to enhance their delivery of an evidence-based suicide protocol and facilitate an evidence-based approach to discharge disposition. Our work was also guided by Phase I reviewers’ concerns. We fully met and exceeded project aims. Most notably, we created a 15-minute avatar (“Dr. Dave”) who performed a portion of the CAMS Suicide Status Interview which was well-liked and described as helpful by suicidal ED patients who interacted with “Dr. Dave.” In Phase II, we propose to complete the development of Virtual CAMS patient and provider tools and to ready it for EHR integration into EPIC. We will again use an agile process of development and seek feedback from target end-users. A diverse group of advisors will consult to us to ensure product excellence and readiness for commercialization. To ensure thorough testing of the product’s provider and patient tools, we will use a two-condition, randomized study to evaluate Virtual CAMS’ efficacy in preventing suicidal behaviors and inappropriate/unnecessary hospital admissions, and improving self-efficacy for coping with acute distress.