A Digital Psychoeducational Social Network Intervention for Suicidal Adolescents

摘要 自杀是美国青少年死亡的第二大原因。青少年因SI或其他原因住院 SA面临着未来SAS和早期死亡的风险；到15年，自杀死亡率可能高达10% 出院后。尽管有这些已知的风险，许多有自杀倾向的青少年在医院后没有得到治疗 这是因为没有经过足够培训的提供者提供有效的自杀预防。因此，有 迫切需要开发可扩展的自杀预防方法。青年提名支持队(YST)是一支3- 对自杀后从医疗机构出院的青少年进行配对的月计划 尝试，与成年人(称为支持成年人)，患者选择作为他们的支持网络。YST 通过培训支持成年人鼓励年轻人坚持以下做法来降低自杀企图的可能性 治疗并做出积极的行为选择。虽然YST很有效，但并不容易按其要求进行扩展 来自精神卫生专业人员(称为YST干预专家)的大量时间承诺以及 需要多个人员的参与和协调。为了缓解这些限制，我们建议 构建EYST，它将通过1)数字化组件来简化YST的运营流程 为青少年、家长和成人提供心理教育培训；2)减轻行政负担 通过将重复性任务自动化，为YST专家提供帮助。因此，本研究有两个主要目的：1)发展EYST， 支持更高效地实施YST的平台；以及2)测试EYST的可行性和可接受性 在单组开放标签试验中。探索性的目标是检查结果的范围和可变性。 与YST相关，包括自杀想法和行为、医疗服务利用率以及对 青少年精神病患者出院前后EYST设计中的成人社会支持 医院。为了开发EYST，我们将使用实施科学框架来了解 利益相关者和系统层面。用于衡量EYST的可接受性和可行性的指标包括 系统可用性评分表的总分平均分、同意参与的指定成年人百分比、 有3名或3名以上成年人参加心理教育等的青年比例20名青年，40 父母/监护人和60名支持儿童的成年人将参加试验。第一阶段的结果将用于通知 筹备未来的SBIR第二期赠款。EYST的商业化将通过健康计划实现。这个 长期目标是显著增加对经过验证的干预的访问，并提供数字和可扩展的解决方案， EYST，最终可以很容易地与行为健康计划的现有基础设施集成 帮助减少年轻人自杀的可能性。

ABSTRACT Suicide is the second leading cause of death among adolescents in the US. Adolescents hospitalized for SI or SA are at risk for future SAs and early mortality; rates of death by suicide may be as high as 10% by 15 years post discharge. Despite these known risks, many suicidal adolescents do not obtain treatment after hospital discharge because there are not enough providers trained to deliver effective suicide prevention. Thus, there is an urgent need to develop scalable suicide prevention methods. Youth-Nominated Support Team (YST) is a 3- month program that pairs adolescents, who are being discharged from a healthcare facility after a suicide attempt, with adults (known as support adults) whom the patient selects to become their support network. YST decreases the likelihood of suicide attempts by training the support adults to encourage youth to adhere to treatment and make positive behavioral choices. While effective, YST is not readily scalable as it requires significant time commitment from mental health professionals (known as YST intervention specialists) and necessitates engagement and coordination from multiple personnel. To mitigate these limitations, we propose to build eYST, which will streamline YST’s operational processes by 1) digitizing components of the psychoeducational training delivered to youth, parents and support adults and 2) reducing administrative burden on the YST specialists by automating repetitive tasks. Thus, this study has two primary aims: 1) develop eYST, a platform to support more efficient implementation of YST; and 2) test the feasibility and acceptability of eYST in a single-group, open-label trial. An exploratory aim is to examine the range and variability of outcomes associated with YST, including suicidal thoughts and behaviors, healthcare service utilization, and perception of adult social support in a pre/post design of eYST with adolescent patients being discharged from a psychiatric hospital. To develop eYST, we will use implementation science frameworks to understand the needs of stakeholders and system-level. Metrics to be used to measure eYST’s acceptability and feasibility include the sum average score of the System Usability Score scale, percentage of nominated adults agreeing to participate, percentage of youth having 3 or more adults participating in the psychoeducation, etc. Twenty youth, 40 parents/guardians, and 60 supporting adults will be enrolled in the trial. Phase I results will be used to inform preparation of a future SBIR Phase II grant. Commercialization of eYST will occur through health plans. The long-term goal is to markedly increase access to a proven intervention and deliver a digital and scalable solution, eYST, that can be easily integrated with the existing infrastructure of behavioral health programs, ultimately aiding in reducing the likelihood of suicide among youth.