Examining feasibility, acceptability, and sustainability of a novel personalized smartphone intervention for suicide.

项目总结/摘要 自杀在美国是一个严重的公共卫生问题。然而，尽管理论上 自杀的模式和治疗，自杀率自1999年以来上升了33%。鉴于广泛的 随着智能手机技术的普及，通过移动的平台提供干预措施的潜力很大。 然而，尽管智能手机自杀工具激增，但很少有人提供基于证据的支持， 包括潜在有害内容。作为回应，我们已经进行了移动的自杀的初步开发 预防系统：防止自杀的移动的应用程序（MAPS）。MAPS是专门设计来识别 增加自杀风险，并为从精神病院出院的患者提供个性化干预， 一个非常高风险的时期。MAPS提供移动的应用程序和临床医生支持，并包括多个 基于证据的组成部分：（1）通过生态瞬间监测思想，情绪和行为 评估（EMA），（2）个性化的，互动的应对策略管理的基础上，参与者的当前 风险状态，（3）直接获得临床医生和危机支持服务，（4）心理教育。我们将利用 MAPS的现有组件，并开发和测试新功能。为了规划MAPS的可持续发展，我们将 通过巴特勒医院过渡门诊计划提供干预，分配参与者 硕士水平的医院临床医生，并召集一个利益相关者咨询委员会，重点是计划 持续发展具体而言，本研究的主要目的是确定可行性、可接受性、安全性和 估计主要结果的关键参数（即，自杀意念和行为;再次住院），以及目标 机构（即，自我监控，使用应对策略，减少负面影响，自我效能）。的 该项目的最终目标是进一步开发和完善MAPS系统，并进行初步测试 准备进行一项完全有效的随机临床试验（R 01），以确定干预措施在以下方面的有效性： 更大的医疗保健系统并进一步优化干预组件和递送（例如，机器学习 技术）。该提案概述了干预程序和临床医生培训计划的完善， 焦点小组和开放和随机试点试验。因此，本研究旨在开发工具， 程序和知识基础的新的干预。

PROJECT SUMMARY/ABSTRACT Suicide is a serious public health concern in the United States. However, despite an increase in theoretical models of and treatments for suicide, the suicide rate has risen 33% since 1999. Given the widespread availability of smartphone technology, there is great potential to deliver interventions via mobile platforms. However, despite the proliferation of smartphone tools for suicide, few offer evidence-based support and some include potentially harmful content. In response, we have conducted initial development of a mobile suicide prevention system: Mobile Application to Prevent Suicide (MAPS). MAPS was specifically designed to identify increased suicide risk and deliver personalized intervention for patients transitioning out of a psychiatric hospital, a time of extraordinarily high risk. MAPS provides both a mobile app and clinician support, and includes multiple evidence-based components: (1) monitoring of thoughts, emotions, and behaviors via ecological momentary assessment (EMA), (2) personalized, interactive coping strategy administration based on participants’ current risk state, (3) direct access to clinicians and crisis support services, and (4) psychoeducation. We will leverage existing components of MAPS and develop and test new features. To plan for sustainability of MAPS, we will deliver the intervention through the Butler Hospital Transitional Outpatient Program, assigning participants to master’s level hospital clinicians, and convene a Stakeholder Advisory Board with a focus on program sustainability. Specifically, the primary aim of this investigation is to establish feasibility, acceptability, safety, and estimate key parameters for primary outcomes (i.e., suicidal ideation and behavior; re-hospitalization), and target mechanisms (i.e., self-monitoring, use of coping strategies, reduction of negative affect, self-efficacy). The ultimate goal of this project is to further develop and refine the MAPS system and engage in preliminary testing in preparation for a fully-powered randomized clinical trial (R01) to establish effectiveness of the intervention in a larger health care system and to further optimize intervention components and delivery (e.g., machine learning techniques). This proposal outlines procedures for intervention and clinician training program refinement through focus groups and open and randomized pilot trials. Thus, the present study is designed to develop the tools, procedures, and knowledge base for a novel intervention.