Treating Drivers of Suicide in Primary Care using Jaspr Health TABA Supplement

使用 Jaspr Health TABA 补充剂治疗初级保健中的自杀驱动者

基本信息

批准号：
10805635
负责人：
Linda A Dimeff
金额：
$ 5万
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：
2023
资助国家：
美国
起止时间：
2023-05-03 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10805635
关键词：
Accident and Emergency department Acute Address Adult Age Agitation American Behavioral Caring Cause of Death Cessation of life Companions Competence Counseling Distress Educational process of instructing Effectiveness Evaluation Evidence based practice Feeling suicidal Health Healthcare Systems Individual Patients Persons Phase Primary Care Public Health Randomized, Controlled Trials Reporting Resources Risk Assessment Suicide Suicide attempt Suicide prevention alcohol misuse alcohol use disorder behavioral health brief intervention coping design design,build,test digital technology evidence base experience flexibility formative assessment improved iterative design pilot test preventive intervention primary care clinic primary care provider prototype public health relevance satisfaction screening skills suicidal suicidal behavior suicidal patient suicidal risk tool treatment as usual

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).

项目概要/摘要自杀在美国仍然是一个严重的公共卫生问题，自那以来自杀率几乎每年都在上升 2005 年，从每 10 万人中 11.0 人增加到 2018 年每 10 万人中 14.8 人，2018 年美国成年人总数为 140 万；自杀未遂，同年还有 1200 万人认真考虑过自杀。使用障碍（AUD）呈指数级增加自杀风险，并且还会干扰自杀预防过去十年的自杀预防举措主要针对医疗保健系统。（HCS）一般而言，初级保健诊所（PCC）尤其如此，因为许多自杀身亡的人都获得了他们的帮助尽管普遍的自杀筛查是在他们死亡前的几个月和一年内进行的，但初级保健提供者（PCP）现在已在 PCC 中常规进行，许多 HCS 和 PCC 都在努力提供基于证据的自杀预防实践（EBP）与 PCC 中通常治疗的其他行为健康 EBP 相同。有效、可靠地帮助 PCC 提供自杀预防 EBP，并增强信心和 PCP 治疗自杀的能力，包括可能干扰这些努力的 AUD。 Jaspr Health（“Jaspr”；R44MH108222）是一个自杀预防平台，最初设计用于急诊室 (ED) 的急性自杀患者提供自杀预防 EBP。 Jaspr 指导患者完成乔布斯的自杀协同评估和管理 (CAMS) 全面的自杀风险评估和致命手段咨询，制定危机稳定计划，以及教授行为技巧，以减少迫在眉睫的痛苦；有现场经验的人 (PLE) 的视频提供智慧；并为护理团队总结了渡过自杀危机的希望，以帮助出院。处置计划。配套应用程序提供出院后的支持结果。比较 Jaspr 与 Care-as-Usual 的试验（RCT；N=31）强烈支持其可行性、可接受性和有效增加 EBP 的输送、减少烦躁和痛苦、提高应对能力自杀念头，并提高急诊科满意度。这个为期 34 个月的快速通道旨在通过扩大 Jaspr Health 的效用来增加其对公共卫生的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死的原因（他们的自杀“驱动力”），同时解决酗酒问题该提案由三个方面定义。项目阶段包括：（1）概念验证正式评估阶段，我们将迭代设计、测试和构建原型（第一阶段；第 1-10 个月）；产品设计和构建形成期评估阶段，我们将设计、构建和测试所有剩余的功能和应用程序（第二阶段；第 11 个月至 22)；(3) 总结性评估阶段，涉及比较 Jaspr 的试点测试 (N=20) 和 RCT (N=120) 自杀预防应用程序和其他在线健康资源（第二阶段；第 23-34 个月）。