mHealth for suicide prevention: Design, development, and feasibility of a scalable SMS-based safety planning intervention

项目总结 年轻人(18-24岁)有自杀念头和行为的比率最高、增长最快， 但最低的精神卫生保健率。态度障碍，例如低感知的治疗需求、时间 自我管理的限制和偏好是心理健康比率低的主要原因 在这个年龄段的治疗。尽管传统精神卫生保健的利用率很低，但年轻人 有兴趣使用自我导向的数字技术来帮助管理他们的心理健康症状。数位 自杀预防干预是克服许多主要态度障碍的关键机会 年轻人在寻求特定于自杀的护理时面临着。它们可以简短、私密，并按需提供 个人日常生活背景下的预防性护理。 我的职业目标是成为一名领先的临床科学家，有一个独立的研究项目，专注于 设计和评估增加自杀机会的科技自杀预防干预措施 预防护理。这项建议是基于我在抑郁症干预和自杀评估方面的经验。 研究。它包括培训和研究活动，使我能够发展：(1)形成方面的专业知识 和以用户为中心的终结性设计方法和可扩展的干预设计，(2)自杀方面的专业知识 成人预防干预措施，(3)数字心理健康干预措施有效试验设计方面的专门知识， (4)实施科学研究方法的能力。在与美国精神健康组织的合作下， 全国最大的心理健康倡导组织，以及有过自杀想法的个人 和行为，我将为年轻人设计一个基于短信的自动安全计划干预。 我提议的干预将通过高使用率的沟通来针对自杀相关的应对 路径。 为了设计这一干预，我将追求以下具体目标：(1)进行以用户为中心的设计 研究活动，包括启发研讨会、设计调查和可用性测试，以开发和改进 基于短信的安全规划干预。我还将制定一项执行计划，以确保 开发的安全计划干预是可持续的和可扩展的，在美国心理健康 组织基础设施。(2)我将对我的短信进行可行性随机对照试验- 对60名有自杀念头和自杀行为的年轻人进行安全计划干预。 这项研究的结果将为R01提供必要的数据，以测试短信的有效性- 基于在线社区环境的安全规划干预。通过该奖项获得的培训将 请允许我发展必要的专业知识，这将开启我的独立职业生涯 成人科技自杀预防干预的调查者。

PROJECT SUMMARY Young adults (ages 18-24) have the highest and fastest growing rates of suicidal thoughts and behaviors, but the lowest rates of mental health care. Attitudinal barriers, such as a low perceived need for treatment, time constraints, and preferences for self-management, are the primary reasons for low rates of mental health treatment among this age group. Despite low utilization of traditional mental health care, young adults are interested in using self-directed digital technologies to help manage their mental health symptoms. Digital suicide prevention interventions represent a key opportunity to overcome many of the major attitudinal barriers young adults face when seeking suicide-specific care. They can be short, private, and provide on-demand preventive care in the context of an individual’s everyday life. My career goal is to become a leading clinical scientist with an independent research program focused on designing and evaluating technology-enabled suicide prevention interventions that increase access to suicide prevention care. This proposal builds on my experience in depression intervention and suicide assessment research. It includes training and research activities that will enable me to develop: (1) expertise in formative and summative user centered design methods and scalable intervention designs, (2) expertise in suicide prevention interventions for adults, (3) expertise in efficient trial designs for digital mental health interventions, and (4) aptitude in implementation science research methods. In partnership with Mental Health America, the nation’s largest mental health advocacy organization, and individuals with lived experience of suicidal thoughts and behaviors, I will design an automated text message-based safety-planning intervention for young adults. My proposed intervention will operate by targeting suicide-related coping via a highly used communication pathway. To design this intervention, I will pursue the following specific aims: (1) conduct user centered design research activities, including elicitation workshops, design surveys, and usability testing to develop and refine the text message-based safety planning intervention. I will also produce an implementation plan to ensure that the developed safety planning intervention is sustainable and scalable within Mental Health America’s organizational infrastructure. (2) I will conduct a feasibility randomized controlled trial of my text message- based safety planning intervention among 60 young adults with current suicidal thoughts and behaviors. Results from this study will provide the data necessary for an R01 that tests the efficacy of the text message- based safety planning intervention in online community settings. The training achieved through this award will allow me to develop the necessary specialized knowledge that will launch my career as an independent investigator of technology-enabled suicide prevention interventions for adults.