Development and testing of a digitally assisted risk reduction platform for youth at high risk for suicide

摘要 尽管努力防止自杀，美国的自杀率仍在攀升，自杀是第二大死亡原因 在年轻人中。虽然对风险青年采取预防性干预措施的办法很有希望， 对于自杀，他们表现出适度的好处，最近的评论得出结论，新的发展是 不仅需要促进更大的有效性，而且还需要提高治疗参与度、依从性和 继续关心这些年轻人。数字化工具，尤其是个人智能手机，前景看好 解决这些问题的途径，并可用于提供对近端风险因素的独特理解， 包括心理困扰、快感缺乏和行为退缩，以及高血压患者的睡眠障碍， 风险个人。此外，数字方法可以提供持续的支持性患者接触，以支持 降低自杀风险。这一快速通道SBIR提案的总体目标是提高以下方面的有效性： 为接受门诊精神卫生保健的青少年提供选择性和有针对性的预防， 测试一个全面的数字平台，使从业者能够整合客观的移动的传感和 符合HIPAA的客户沟通工具纳入他们对这些年轻人的管理。我们有 开发了这些产品的初始MVP版本，在第一阶段将采用以用户为中心的设计原则 增强产品与医疗保健组织中典型服务交付系统的匹配度， 高风险个体（即，密集门诊服务）。第二阶段的目标是进一步优化这些 并对产品的有效性、可行性和可接受性进行实用的临床试验 在一个真实的世界密集的门诊临床服务。我们将利用本试验产生的数据， 在实施科学的指导下，采用、实施保真度和持续使用这些工具 框架.

ABSTRACT Despite efforts to prevent suicide, US rates are climbing, and suicide is the second leading cause of death amongst youth. Although promising approaches are available for preventative interventions with youth at-risk for suicide, they demonstrate modest benefit, and recent reviews have concluded that new developments are required that facilitate not only greater effectiveness, but also enhance treatment engagement, adherence, and continuity of care amongst these young people. Digital tools, especially personal smartphones, are promising avenues to address these issues and can be used to provide a unique understanding of proximal risk factors, including psychological distress, anhedonia and behavioral withdrawal, and sleep disturbance amongst high- risk individuals. Furthermore, digital methods can provide ongoing supportive patient contact to support the reduction of suicide risk. The overall aim of this Fast-track SBIR proposal is to enhance the effectiveness of selective and indicated prevention for youth who are received outpatient mental health care by developing and testing a comprehensive digital platform that allows practitioners to integrate objective mobile sensing and HIPAA compliant client communication tools into their management of these young people. We have developed an initial MVP version of these products, and in Phase I will utilize user-centered design principles to enhance the product fit with typical service delivery systems found in healthcare organizations working with high-risk individuals (i.e., intensive outpatient services). The aim of Phase II is to further optimize these products and conduct a pragmatic clinical trial of the effectiveness, feasibility, and acceptability of the products in a real world intensive outpatient clinical service. We will utilize the data generated by this trial to improve adoption, implementation fidelity, and sustained use of these tools, guided by an implementation science framework.