Treating Drivers of Suicide in Primary Care using Jaspr Health

使用 Jaspr Health 在初级保健中治疗自杀驱动者

基本信息

批准号：
10383171
负责人：
Linda A Dimeff
金额：
$ 39.8万
依托单位：
EVIDENCE-BASED PRACTICE INSTITUTE, INC.
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-10 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10383171
关键词：
Accident and Emergency department Acute Address Administrator Adoption Adult Age Agitation American Behavioral Caring Cause of Death Cessation of life Clinic Companions Competence Contracts Counseling Development Distress Effectiveness Emergency Department patient Ensure Evaluation Evidence based intervention Evidence based practice Feeling suicidal Health Health Personnel Healthcare Healthcare Systems Home Human Resources Individual Mental Health Services Methods Movement Occupations Outpatients Pain Participant Patient Recruitments Patients Persons Phase Prevention strategy Primary Health Care Procedures Process Public Health Randomized Controlled Trials Recovery Reporting Research Methodology Resources Risk Assessment Running Self Efficacy Suicide Suicide attempt Suicide prevention Technology Testing Time Treatment Effectiveness United States Visit active control alcohol misuse alcohol use disorder base behavioral health brief intervention care providers clinically relevant comorbidity coping design digital emotional distress evidence base experience flexibility formative assessment functional improvement health goals improved iterative design preventive intervention prototype public health relevance reducing suicide satisfaction screening skills smartphone Application suicidal suicidal behavior suicidal patient suicidal risk tool trial comparing user centered design

项目摘要

PROJECT SUMMARY/ABSTRACT Suicide remains a serious public health problem in the U.S. as rates have risen nearly each year since 2005, from 11.0 per 100,000 to 14.8 per 100,000 in 2018, totaling 48,344 in 2018; 1.4 million U.S. adults made a suicide attempt, and another 12 million thought seriously about killing themselves that same year. Alcohol use disorder (AUD) exponentially increases suicide risk and can also interfere with suicide prevention intervention efforts. Suicide prevention initiatives over the past decade have targeted healthcare systems (HCS) in general and primary care clinics (PCC) in particular because so many who die by suicide access their primary care provider (PCP) in the months and year prior to their death. Though universal suicide screening is now routinely conducted in PCC, many HCS and PCC struggle to provide suicide prevention evidence-based practices (EBP) on par with other behavioral health EBP commonly treated in PCC. Digital technologies can efficiently and reliably help deliver suicide prevention EBP in PCC and increase the confidence and competence of PCP in treating suicide, including AUD that may interfere with these efforts. Jaspr Health (“Jaspr”; R44MH108222) is a suicide prevention platform originally designed for use by acutely suicidal patients in emergency departments (ED) to deliver suicide prevention EBP. Grounded in Jobes’ Collaborative Assessment and Management of Suicidality (CAMS), Jaspr guides patients in completing a comprehensive suicide risk assessment and lethal means counseling, builds a crisis stabilization plan, and teaches behavioral skills to reduce imminent distress; videos of people with live experience (PLE) offer wisdom and hope for getting through suicide crises. Information is summarized for the care team to aid in discharge disposition planning. A companion app provides support post-discharge. Results from a randomized controlled trial (RCT; N=31) comparing Jaspr to Care-as-Usual strongly support its feasibility, acceptability, and effectiveness in increasing delivery of EBP, reducing agitation and distress, improving capacity to cope with suicidal thoughts, and improving ED satisfaction. This 34-month fast track seeks to increase the public health impact of Jaspr Health by extending its utility to deliver evidence-based brief interventions that directly target and treat a person’s reasons for wanting to die (their “drivers” for suicide) while simultaneously addressing alcohol misuse. The proposal is defined by three project stages which include: (1) a proof-of-concept formative evaluation stage where we will iteratively design, test, and build a prototype (Phase I; Months 1-10); (2) a product design-and-build formative evaluation stage, where we will design, build and test all remaining features and apps (Phase II; Months 11- 22); and (3) a summative evaluation stage involving a pilot test (N=20) and a RCT (N=120) comparing Jaspr to a suicide prevention app and other online wellness resources (Phase II; Months 23-34).

项目摘要/摘要自从美国，自杀仍然是一个严重的公共卫生问题，因为自来的利率几乎每年都在增加 2005年，2018年的每100,000每100,0001.0至14.8，2018年总计48,344； 140万美国成年人自杀企图，另外1200万个考虑了同年自杀。酒精使用障碍（AUD）成倍增加自杀风险，也可能干扰预防自杀干预工作。过去十年来，预防自杀计划针对医疗系统（HCS）一般和初级保健诊所（PCC），因为许多因自杀而死的人初级保健提供商（PCP）在其去世前的几个月和一年中。尽管普遍的自杀筛查是现在，许多HCS和PCC都在PCC中进行例行进行，以提供预防自杀的循证与PCC中通常治疗的其他行为健康EBP相当的实践（EBP）。数字技术可以有效，可靠地帮助PCC中的自杀预防EBP，并提高信心和 PCP在治疗自杀方面的能力，包括可能干扰这些努力的AUD。 JASPR Health（“ JASPR”; R44MH108222）是一个自杀的预防平台，该平台最初旨在使用急诊科（ED）的急性自杀患者提供预防自杀性EBP。接地乔布斯的自杀式合作评估和管理（CAMS），JASPR指导患者完成全面的自杀风险评估和致命性意味着咨询，建立危机稳定计划，并教授行为技巧以减少迫在眉睫的困扰；有现场经验的人（PLE）提供智慧的视频并希望通过自杀犯罪。总结信息以帮助护理团队帮助出院处置计划。伴侣应用程序提供支持后的支持。随机控制的结果试验（RCT; n = 31）将JASPR与普通话进行比较，强烈支持其可行性，可接受性和在增加EBP的交付，减少搅动和困扰，提高能力应对的能力方面的有效性自杀思想，并提高ED满意度。这个34个月的快速轨道旨在通过扩展其公用事业来增加JASPR健康的公共卫生影响提供基于证据的简短干预措施，直接针对和治疗一个人想要死的原因（他们自杀的“司机”）同时解决滥用酒精。该提案由三个定义项目阶段包括：（1）概念验证的形成性评估阶段，我们将在其中迭代设计，测试和构建原型（第一阶段； 1-10个月）；（2）产品设计和构建格式评估阶段，我们将在其中设计，构建和测试所有其余功能和应用程序（第二阶段； 11-月份 - 22）; （3）涉及试点测试（n = 20）和RCT（n = 120）的总结性评估阶段进行比较JASPR 预防自杀应用和其他在线健康资源（第二阶段；第23-34个月）。