Signature Research Project

JASPR（签名项目）：摘要 意义：这个签名项目的意义来自于它的强大组合（1） 针对高危人群-前往急诊室就诊的有自杀风险的成年患者; (2)解决阻碍提供与自杀有关的循证做法的明显障碍 （EBP）在艾德通过创新，多组件，NIMH资助的技术称为Jaspr;和（3） 评估Jaspr的功效，有效性和实施，所有这些都在同一个高效的研究中。 研究人员：Jaspr的项目团队率先使用连续的、基于艾德系统的自杀预防。 质量改进实施策略（Boudreaux、Kiefe、Larkin、约翰逊、Volturo）;数字行为 保健技术开发和部署（Boudreaux、Dimeff、Gerber）;采用多种方法， 包括患者报告的指标、电子健康记录（EHR）数据和死亡登记， 干预目标确定（Boudreaux，Kiefe，Gerber）;实施科学研究设计， 分析方法学（Kiefe，Yang，Larkin）和医疗保健经济学（Singh，Clements）。 创新：这将是第一项全面评估多组分自杀预防的研究。 一种技术，有助于提供与自杀有关的电子商务，同时用生产性的替代浪费的等待时间 时间它的多组分特性满足了采用零自杀系统的几个关键性能要素。 一种新颖的、获奖的混合研究设计，称为互补随机对照试验和真实世界试验。 将使用疗效、有效性和实施设计研究（CREID）。 方法：CREID由两个独立但相关的组成部分或部分组成。A部分，随机对照 试验（RCT）将是一项患者水平、随机、平行组、单盲试验（n=670），比较Jaspr （干预）到常规强化治疗（ETAU;活性对照药物对照）。与NIMH一致 实验治疗学范式，A部分的主要目的是确定Jaspr在改善自杀方面的疗效， 首次艾德访视后12个月内的相关结局，并探索其潜在作用机制 通过参与患者干预目标和EBP交付。在B部分，真实世界研究中，四种不同的ED 将Jaspr作为日常护理的一部分。B部分的主要目的是评估Jaspr的有效性， 在现实世界中使用。最后，这两个部分将用于探索Jaspr的实现，包括 建立系统、临床医生和患者因素，预期会影响Jaspr的采用和实现。 环境：马萨诸塞大学陈医学院（马萨诸塞大学），Jaspr健康，和合作组织有 证明了他们有能力支持这项雄心勃勃的研究，他们成功地与许多NIMH资助的，基于系统的 自杀预防研究和SBIR/STTR技术赠款，包括创建Jaspr的SBIR。 影响：加速了Jaspr的翻译，增进了与实施 艾德环境中的自杀护理技术有可能每年帮助成千上万的自杀者。

JASPR (SIGNATURE PROJECT): ABSTRACT Significance: The significance of this Signature Project is derived from its powerful combination of (1) targeting a high-risk population -- adult patients at risk for suicide presenting to emergency departments (EDs); (2) addressing trenchant barriers that have prevented delivery of suicide-related evidence-based practices (EBPs) in the ED through an innovative, multi-component, NIMH-funded technology called Jaspr; and (3) evaluating Jaspr’s efficacy, effectiveness, and implementation, all in the same highly efficient study. Investigators: Jaspr’s project team has pioneered ED systems-based suicide prevention using continuous quality improvement implementation strategies (Boudreaux, Kiefe, Larkin, Johnson, Volturo); digital behavioral health technology development and deployment (Boudreaux, Dimeff, Gerber); using multi-method approaches, including patient-reported measures, electronic health record (EHR) data, and death registries, for outcome and intervention target ascertainment (Boudreaux, Kiefe, Gerber); implementation science research design and analytic methodologies (Kiefe, Yang, Larkin); and healthcare economics (Singh, Clements). Innovation: This will be the first study to comprehensively evaluate a multi-component suicide prevention technology that facilitates delivery of suicided-related EBPs while replacing wasted waiting time with productive time. Its multi-component nature satisfies several key performance elements for systems adopting Zero Suicide. A novel, award-winning hybrid study design called Complementary Randomized Controlled Trial and Real-World Study for Efficacy, Effectiveness, and Implementation Design (CREID) will be used. Approach: CREID comprises two separate but related components or parts. Part A, Randomized Controlled Trial (RCT), will be a patient-level, randomized, parallel-arm, single-blind trial (n=670) comparing Jaspr (Intervention) to enhanced treatment as usual (ETAU; Active Comparator Control). Consistent with NIMH’s experimental therapeutics paradigm, Part A’s primary aim is to determine Jaspr’s efficacy in improving suicide- related outcomes in the 12 months after the index ED visit and to explore its potential mechanisms of action through engaging patient intervention targets and EBP delivery. In Part B, Real-World Study, four diverse EDs will implement Jaspr as part of routine care. Part B’s primary aim will be to evaluate Jaspr’s effectiveness when used in a real-world setting. Finally, both Parts will be used to explore Jaspr’s implementation, including establishing system, clinician, and patient factors anticipated to affect Jaspr adoption and implementation. Environment: The UMass Chan Medical School (UMass), Jaspr Health, and partnering organizations have proven their ability to support this ambitious study by their success with numerous NIMH-funded, systems-based suicide prevention studies and SBIR/STTRs technology grants, including the SBIR that created Jaspr. Impact: Accelerated translation of Jaspr and advancing knowledge pertaining to the implementation of suicide care technologies in the ED setting has the potential to help thousands of suicidal individuals annually.