Signature Research Project

JASPR(签名项目)：摘要 意义：这个标志性项目的意义来自于它强大的组合(1) 针对高危人群--有自杀风险的成年患者到急诊科就诊； (2)消除阻碍提供与自杀有关的循证做法的尖锐障碍 (3)通过NIMH资助的名为JASPR的创新、多组件技术在教育部门实施(EBPS)；以及 在同一项高效率的研究中，评估JASPR的有效性、有效性和实施情况。 调查人员：JASPR的项目组开创了基于ED系统的自杀预防系统，使用连续 质量改进实施战略(Boudreaux、Kiefe、Larkin、Johnson、Volturo)；数字行为 卫生技术的开发和部署(布德罗、迪梅夫、格伯)；使用多种方法， 包括患者报告的测量、电子健康记录(EHR)数据和死亡登记，以获得结果和 干预目标确定(Boudreaux、Kiefe、Gerber)；实施科学研究设计和 分析方法论(Kiefe，Yang，Larkin)；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 促进与自杀相关的EBP的交付，同时将浪费的等待时间替换为高效的 时间到了。它的多组件特性满足采用零自杀的系统的几个关键性能要素。 一项名为互补随机对照试验和真实世界的新型获奖杂交研究设计 将使用有效性研究和实施设计(CRID)。 方法：CRID由两个独立但相关的组件或部件组成。A部分，随机控制 试验(RCT)，将是一项患者水平的、随机、平行、单盲试验(n=670)，比较JASPR (干预)到照常加强治疗(Etau；主动对照对照)。与NIMH一致 实验治疗学范式，A部分的主要目标是确定JASPR在改善自杀方面的有效性- 指数ED访问后12个月的相关结果及其可能的作用机制 通过接触患者干预目标和EBP交付。在B部分，真实世界研究中，四个不同的ED 将实施JASPR作为常规护理的一部分。B部分的主要目标是在以下情况下评估JASPR的有效性 在真实环境中使用。最后，我们将使用这两个部分来探索Jaspr的实现，包括 建立预计会影响JASPR采用和实施的系统、临床医生和患者因素。 环境：马萨诸塞州大学陈冯富珍医学院、Jaspr Health和合作组织 他们的成功证明了他们有能力支持这项雄心勃勃的研究，成功地使用了许多由NIMH资助、基于系统的研究 自杀预防研究和SBIR/STTRS技术赠款，包括创建JASPR的SBIR。 影响：加速翻译JASPR并增进与实施 ED环境中的自杀护理技术每年有可能帮助成千上万有自杀倾向的人。

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.