Text Message Reminders for Suicide Prevention

Age: Any Age

Sex: Any

Trial Phase: Phase 2

Sponsor: University of Texas Southwestern Medical Center

Disqualifiers: Non-English speaking

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Prior Safety Data This treatment has passed at least one previous human trial

Compensation: Varies

Number of Visits: 2

Duration: 6 months

61 Participants Needed

Trial Summary

Do I need to stop my current medications to join the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the idea that Text Message Reminders for Suicide Prevention is an effective treatment?

The available research shows that text message reminders for suicide prevention are technically feasible and accepted by patients. In a pilot study, patients who received text messages after a suicide attempt found them to have a positive preventive impact. This method is also more cost-effective and easier to use compared to other strategies like phone calls or postcards. This suggests that text message reminders can be an effective way to support individuals after a suicide attempt. ^{1 2 3 4 5}

What safety data exists for text message reminders in suicide prevention?

The research indicates that text message reminders are generally safe, with no reports of adverse events such as misreading, misinterpreting data, privacy issues, or message delivery failures. However, there is a need for personalized messages to better meet individual needs. ^{6 7 8 9 10}

Is the treatment Safe Home Text Message Reminders a promising treatment for suicide prevention?

Yes, Safe Home Text Message Reminders is a promising treatment for suicide prevention. Text messaging has been shown to be effective in improving health behaviors and outcomes, such as increasing appointment attendance and supporting behavior change. It is also cost-effective, quick, and widely accessible, making it a valuable tool for reaching people who need support. ^{6 7 11 12 13}

What is the purpose of this trial?

Study Objective: to develop a phone-based intervention to aid parents of suicidal adolescents to adhere to lethal means safety. Lethal means counseling is the practice of educating patients and their families about limiting access to items that can be used to attempt suicide. Though lethal means counseling is standard practice in treating suicidal patients, there is little experimental literature related to its utilization across different providers and its efficacy. Further, there is a significant gap in the literature on lethal means counseling as it relates to adolescents. The proposed project will investigate a novel text message-based intervention aimed to promote lethal means safety.

Eligibility Criteria

This trial is for parents or legal guardians of adolescents aged 12-17 who are patients at Children's Health SPARC IOP. Participants must be adults (18+), own a smartphone with internet, and be proficient in English. Non-English speakers cannot participate.

Inclusion Criteria

I am the parent or legal guardian of an adult participant.

I am a teenager aged 12-17 receiving care at Children's Health SPARC IOP.

Proficiency in spoken and written English

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Treatment

Parents in the intervention group receive text message reminders to restrict lethal means for 6 months

6 months

Bi-weekly text messages

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

Assessments at SPARC discharge, 1 month, and 6 months post-discharge

Treatment Details

Interventions

• Safe Home Text Message Reminders

Trial Overview The study is testing a new intervention: text message reminders sent to parents to help them secure potentially dangerous items from suicidal adolescents. It aims to improve adherence to lethal means safety advice given by healthcare providers.

Participant Groups

Group I: Text Message Intervention Experimental Treatment 1 Intervention

Parents in the intervention arm will receive text message reminders to restrict lethal means for 6 months.

Group II: Treatment as Usual Active Control 1 Intervention

Parents in the treatment as usual group will not receive the text message intervention.

Who Is Running the Clinical Trial?

University of Texas Southwestern Medical Center

Lead Sponsor

Trials

1,102

Recruited

1,077,000+

Findings from Research

The pilot phase of the SmartCrisis 2.0 trial demonstrated that a smartphone-based safety plan for patients with recent suicidal behavior is feasible and well-accepted, with a participation rate of 77% and high satisfaction ratings (overall satisfaction score of 9.6 out of 10).

Patients found the safety plan useful (7.4/10) and easy to use (8.9/10), with common coping strategies including walking and exercise, indicating that the app could be a valuable tool in clinical practice for supporting mental health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Smartphone-based safety plan for suicidal crisis: The SmartCrisis 2.0 pilot study. Porras-Segovia, A., De Granda-Beltrán, AM., Gallardo, C., et al.[2023]

The 'Lock to Live' decision aid for lethal means safety shows promise in helping emergency department clinicians counsel patients at risk of suicide, based on qualitative interviews with 15 clinicians.

Successful implementation of the tool depends on clinicians' perceptions of its utility, time constraints, and how well it fits into the existing emergency department workflow.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lethal means counseling for suicide prevention: Views of emergency department clinicians. Siry, BJ., Polzer, E., Omeragic, F., et al.[2022]

A pilot study involving 18 post-suicidal patients demonstrated that text messaging outreach is technically feasible and was well-accepted by participants, who reported a positive impact on their recovery.

Text messaging offers a cost-effective and convenient alternative to traditional post-acute care strategies, suggesting potential for broader implementation and the need for further research to evaluate its efficacy in preventing post-acute suicidal behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Post-acute crisis text messaging outreach for suicide prevention: a pilot study. Berrouiguet, S., Gravey, M., Le Galudec, M., et al.[2018]

The study tested different methods to promote the use of Lock to Live (L2L), a web-based tool for safe storage of firearms and medications, among patients with suicide ideation, reaching 2,729 patients overall.

The most effective method was sending an Electronic Health Record (EHR) message combined with two email reminders, resulting in an 11% visitation rate to L2L, while provider referrals had a 100% uptake but reached only 14 patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"Lock to Live" for firearm and medication safety: Feasibility and acceptability of a suicide prevention tool in a learning healthcare system. Boggs, JM., Quintana, LM., Beck, A., et al.[2022]

The 'Lock to Live' decision aid was developed through 64 stakeholder interviews with adults connected to suicide prevention and firearm access, aiming to help individuals choose safe firearm storage options to reduce suicide risk.

The decision aid received high user acceptability and could potentially improve lethal means counseling, contributing to efforts in preventing firearm-related suicides if proven effective in future trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

'Lock to Live': development of a firearm storage decision aid to enhance lethal means counselling and prevent suicide. Betz, ME., Knoepke, CE., Siry, B., et al.[2022]

This study aims to evaluate the effectiveness of different reminder methods (text messages, reminder calls, or both) in increasing the use of service referrals among 300 participants from community outreach programs.

The research will help determine how mobile phone-based interventions can enhance community engagement and service utilization, potentially guiding future reminder protocols for similar programs across the country.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Research Protocol to Test the Effectiveness of Text Messaging and Reminder Calls to Increase Service Use Referrals in a Community Engagement Program. Varma, DS., Hart, M., McIntyre, DS., et al.[2020]

A systematic review of 162 studies found that SMS reminders significantly improve patient medical compliance and appointment attendance, highlighting their effectiveness as a health care intervention.

The use of SMS reminders is associated with benefits such as ease of use, low cost, and high acceptability among patients, with minimal reported risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using text message reminders in health care services: A narrative literature review. Schwebel, FJ., Larimer, ME.[2022]

A study involving 277 adults found that individuals aged 51 and older have distinct messaging preferences compared to those under 50, particularly favoring direct 'you' statements over collective 'we' statements.

Older adults also prefer messages without emoticons, indicating that tailoring text message interventions to these preferences could enhance engagement and effectiveness in health-related communications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An exploratory study of mobile messaging preferences by age: Middle-aged and older adults compared to younger adults. Kuerbis, A., van Stolk-Cooke, K., Muench, F.[2022]

In a study involving 1,677 children with uncomplicated malaria, SMS reminders significantly improved the likelihood of returning to the health facility for follow-up visits on day 3 and day 28, but did not significantly affect adherence to the medication regimen of artemether-lumefantrine (AL), which was already high in both groups.

The results suggest that while SMS reminders can enhance post-treatment attendance, they may not be necessary for improving medication adherence, indicating a need for further research in real-world settings to explore their full potential.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of text-message reminders on paediatric malaria treatment adherence and their post-treatment return to health facilities in Kenya: a randomized controlled trial. Talisuna, AO., Oburu, A., Githinji, S., et al.[2022]

In a study involving 59 hospital workers, sending short text messages (SMS) proved to be an effective additional notification tool for alerting staff during emergencies, such as fires or mass casualty incidents.

The average response time to the SMS was about 36 minutes, and after adjusting for outliers, the estimated mean arrival time at the hospital was approximately 38 minutes, indicating that SMS can facilitate quicker mobilization of medical personnel.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Short Text Messages (SMS) as an Additional Tool for Notifying Medical Staff in Case of a Hospital Mass Casualty Incident. Timler, D., Bogusiak, K., Kasielska-Trojan, A., et al.[2016]

A study involving 91 cardiac surgery patients and 156 family members demonstrated that real-time SMS updates about patient status were successfully delivered to 73% of families, providing reassurance during critical moments.

Feedback from participants indicated that the SMS service was easy to understand, did not increase anxiety, and was highly recommended for use with other families, highlighting its effectiveness in improving communication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Successful implementation of a short message service (SMS) as intensive care to family communication tool. Gorman, K., MacIsaac, C., Presneill, J., et al.[2023]

Text messaging interventions significantly improve smoking cessation rates, with smokers receiving these messages being 38% more likely to abstain from smoking compared to control groups, based on a meta-analysis of 20 studies involving over 15,500 participants.

These interventions not only help with quitting but also reduce overall cigarette consumption, making them an effective tool for public health initiatives aimed at reducing tobacco use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis. Scott-Sheldon, LA., Lantini, R., Jennings, EG., et al.[2022]

Text messaging programs can effectively help individuals change health behaviors, leveraging automated and interactive messages to guide users through the behavior change process.

The authors provide a structured guide for developing these programs, emphasizing the importance of formative research, design, pretesting, and revision to ensure the program meets the needs of the target audience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing and Pretesting a Text Messaging Program for Health Behavior Change: Recommended Steps. Abroms, LC., Whittaker, R., Free, C., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Smartphone-based safety plan for suicidal crisis: The SmartCrisis 2.0 pilot study. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Lethal means counseling for suicide prevention: Views of emergency department clinicians. [2022]

3. Ireland pubmed.ncbi.nlm.nih.gov

Post-acute crisis text messaging outreach for suicide prevention: a pilot study. [2018]

4. Switzerland pubmed.ncbi.nlm.nih.gov

"Lock to Live" for firearm and medication safety: Feasibility and acceptability of a suicide prevention tool in a learning healthcare system. [2022]

5. England pubmed.ncbi.nlm.nih.gov

'Lock to Live': development of a firearm storage decision aid to enhance lethal means counselling and prevent suicide. [2022]

6. Canada pubmed.ncbi.nlm.nih.gov

A Research Protocol to Test the Effectiveness of Text Messaging and Reminder Calls to Increase Service Use Referrals in a Community Engagement Program. [2020]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Using text message reminders in health care services: A narrative literature review. [2022]

8. England pubmed.ncbi.nlm.nih.gov

An exploratory study of mobile messaging preferences by age: Middle-aged and older adults compared to younger adults. [2022]

9. England pubmed.ncbi.nlm.nih.gov

Efficacy of text-message reminders on paediatric malaria treatment adherence and their post-treatment return to health facilities in Kenya: a randomized controlled trial. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Short Text Messages (SMS) as an Additional Tool for Notifying Medical Staff in Case of a Hospital Mass Casualty Incident. [2016]

11. Netherlands pubmed.ncbi.nlm.nih.gov

Successful implementation of a short message service (SMS) as intensive care to family communication tool. [2023]

12. Canada pubmed.ncbi.nlm.nih.gov

Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis. [2022]

13. Canada pubmed.ncbi.nlm.nih.gov

Developing and Pretesting a Text Messaging Program for Health Behavior Change: Recommended Steps. [2022]