Jaspr App for Suicide Prevention

(Jaspr-PartA Trial)

Overseen By Mhd B Rahmoun, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Massachusetts, Worcester

Disqualifiers: Prisoners, Unable to consent, Under 18, others

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

Compensation: Varies

Number of Visits: 7

Duration: 1 day

670 Participants Needed

Trial Summary

What is the purpose of this trial?

This Study will comprehensively evaluate a multi-component suicide prevention technology (Jaspr Health) that facilitates delivery of suicided-related evidence-based practices (EBPs) while replacing wasted waiting time with productive time in the Emergency Departments (EDs). The EBPs satisfy several key performance elements for systems adopting Zero Suicide. A Complementary Randomized Controlled Trial and Real-World Study for Efficacy, Effectiveness, and Implementation Study Design (CREID) will be used

Will I have to stop taking my current medications?

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

What data supports the effectiveness of the treatment Jaspr App for Suicide Prevention?

Research shows that mobile apps can help manage suicidal thoughts and self-harm by providing tools like safety plans and mood tracking. The Jaspr Health app, used in emergency departments, delivers evidence-based practices directly to patients, which can improve care for those experiencing a psychiatric crisis. ^{1 2 3 4 5}

Is the Jaspr App for Suicide Prevention safe for use in humans?

The available research does not specifically address the safety of the Jaspr App, but it is designed to deliver evidence-based practices for suicide prevention in emergency departments, suggesting it is intended to be a safe tool for patients. ^{1 2 4 6 7}

How is the Jaspr App for Suicide Prevention treatment different from other treatments for suicide prevention?

The Jaspr App for Suicide Prevention is unique because it is a tablet-based app designed for direct use by patients in emergency departments, delivering four evidence-based practices for suicide prevention. This digital approach allows for scalable, immediate support without the need for extensive time and personnel resources, which is often a limitation in traditional emergency care settings. ^{1 2 3 6 7}

Research Team

Edwin D Boudreaux, PhD

Principal Investigator

University of Massachusetts, Worcester

Eligibility Criteria

This trial is for individuals in emergency departments who have attempted suicide, are having suicidal thoughts, or engaged in self-harm. Specific eligibility details aren't provided, but typically participants must meet certain health criteria to be included.

Inclusion Criteria

Positive for suicide risk on the Patient Safety Screener in the ED (active suicidal ideation in the past 2 weeks, or suicidal attempt in the past 6 months)

Reliable telephone access

Reads English at 6th grade level

Exclusion Criteria

I am under 18 years old.

I am unable to give consent for myself.

Enrolled subjects during the 12 month follow-up period

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 day

1 visit (in-person)

Treatment

Participants use the Jaspr Health app during their ED visit, completing the Suicide Status Interview and accessing safety planning and coping skills modules.

1 day

1 visit (in-person)

Follow-up

Participants receive follow-up phone calls to assess suicide-related outcomes and healthcare utilization.

12 months

5 visits (virtual)

Long-term monitoring

Review of Massachusetts Department of Public Health death registry and electronic health records for additional monitoring.

12 months

Treatment Details

Interventions

• ETAU
• Jaspr App + JAH

Trial Overview The study is testing the Jaspr Health app combined with Just-in-Time Adaptive Help (JAH) against usual treatment. It aims to use patients' waiting time effectively by providing evidence-based practices for suicide prevention.

Participant Groups

Group I: Jaspr intervention with enhanced treatment as usual (ETAU) Experimental Treatment 2 Interventions

Subjects in this arm will receive ETAU in addition, they will complete a guided Suicide Status Interview (SSI), Safety Planning, and Lethal means counseling on the Jaspr tablet-based app before open access to the Jaspr resource library. Subjects can sign up to receive JAH mobile app.

Group II: Enhanced treatment as usual (ETAU) alone Active Control 1 Intervention

Subjects in this arm will receive the usual care for patients with suicidal risk at UMass Memorial ED that may include a behavioral health evaluation by a trained clinician, and environmental safety precautions dictated by risk level (Mild, Moderate, High). Individuals deemed appropriate for discharge undergo discharge planning and offered a personalized safety plan using the Stanley-Brown Safety Planning Intervention, including lethal means safety counseling.

Who Is Running the Clinical Trial?

University of Massachusetts, Worcester

Lead Sponsor

Trials

372

Recruited

998,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Evidence-Based Practice Institute, Seattle, WA

Industry Sponsor

Trials

9

Recruited

29,800+

Ohio State University

Collaborator

Trials

891

Recruited

2,659,000+

University of Colorado, Denver

Collaborator

Trials

1,842

Recruited

3,028,000+

Worcester Polytechnic Institute

Collaborator

Trials

19

Recruited

30,000+

Findings from Research

The Jaspr Health app was found to be feasible and acceptable for use among acutely suicidal patients in emergency departments, with high user satisfaction and no adverse events reported during the study.

Participants using the app experienced significant improvements, including increased access to evidence-based suicide prevention interventions and reductions in distress and agitation, compared to those receiving standard care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using a Tablet-Based App to Deliver Evidence-Based Practices for Suicidal Patients in the Emergency Department: Pilot Randomized Controlled Trial. Dimeff, LA., Jobes, DA., Koerner, K., et al.[2023]

Digital interventions, such as apps, showed a reduction in suicidal ideation scores among 3,356 participants across 14 studies, suggesting they may be more effective than simply waiting for treatment.

However, there was no evidence that these interventions reduced self-harm or suicide attempts, and many studies had design biases, indicating that more research is needed to confirm their safety and effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of online and mobile telephone applications ('apps') for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis. Witt, K., Spittal, MJ., Carter, G., et al.[2022]

The mobile app developed as part of the SERO suicide prevention program aims to reduce suicides and suicide attempts by enhancing self-management for individuals at risk, incorporating strategies like safety planning and mood tracking.

The app's design was informed by collaboration among health professionals, individuals at risk, and their families, ensuring it addresses real needs and integrates essential suicide prevention strategies effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

SERO - A New Mobile App for Suicide Prevention. Meier, L., Gurtner, C., Nuessli, S., et al.[2022]

The study involving 20 adolescents discharged from a mental health ward showed that the smartphone apps BeyondNow and BlueIce were feasible and acceptable, with most participants accessing them at least once during the six-week follow-up.

While many participants found the apps easy to use, a significant portion (47%) felt they would not ensure safety during a crisis; however, improvements in suicide resilience were noted, indicating potential benefits in managing self-harm and suicidal behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The feasibility of using smartphone apps to manage self-harm and suicidal acts in adolescents admitted to an inpatient mental health ward. Muscara, F., Ng, O., Crossley, L., et al.[2022]

The research aims to implement the Hope app in the psychiatric emergency department at the Centre for Addiction and Mental Health to enhance suicide safety planning, involving ED clinicians and service users in the process to ensure effective integration into clinical workflows.

By using a co-design approach, the study will identify barriers and facilitators to implementation, ultimately developing strategies that support clinicians in adopting the app, which is crucial for improving suicide prevention efforts in emergency settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Designing Implementation Strategies for a Digital Suicide Safety Planning Intervention in a Psychiatric Emergency Department: Protocol for a Multimethod Research Project. Shin, HD., Zaheer, J., Torous, J., et al.[2023]

The pilot study involving 66 adolescents showed that the ASAP intervention, which includes a smartphone app for emotion regulation, did not significantly reduce suicide attempts post-discharge, but indicated a trend towards fewer attempts (16% vs. 31%).

Participants with a history of previous suicide attempts may benefit more from the ASAP intervention, suggesting that this program could be tailored for those at higher risk, and overall, the intervention and app were well-received by users.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

As Safe as Possible (ASAP): A Brief App-Supported Inpatient Intervention to Prevent Postdischarge Suicidal Behavior in Hospitalized, Suicidal Adolescents. Kennard, BD., Goldstein, T., Foxwell, AA., et al.[2023]

The CASPAR study aims to evaluate the feasibility of using mobile health applications for safety planning and daily self-monitoring in 80 patients with major depressive disorder or dysthymia at risk for suicidal behavior.

By integrating mobile safety plans and symptom tracking into routine care, the study seeks to enhance understanding of the suicidal process and improve treatment outcomes for high-risk patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Smartphone-based safety planning and self-monitoring for suicidal patients: Rationale and study protocol of the CASPAR (Continuous Assessment for Suicide Prevention And Research) study. Nuij, C., van Ballegooijen, W., Ruwaard, J., et al.[2023]

References

1. Canada pubmed.ncbi.nlm.nih.gov

Using a Tablet-Based App to Deliver Evidence-Based Practices for Suicidal Patients in the Emergency Department: Pilot Randomized Controlled Trial. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Effectiveness of online and mobile telephone applications ('apps') for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis. [2022]

3. Netherlands pubmed.ncbi.nlm.nih.gov

SERO - A New Mobile App for Suicide Prevention. [2022]

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

The feasibility of using smartphone apps to manage self-harm and suicidal acts in adolescents admitted to an inpatient mental health ward. [2022]

5. Canada pubmed.ncbi.nlm.nih.gov

Designing Implementation Strategies for a Digital Suicide Safety Planning Intervention in a Psychiatric Emergency Department: Protocol for a Multimethod Research Project. [2023]

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

As Safe as Possible (ASAP): A Brief App-Supported Inpatient Intervention to Prevent Postdischarge Suicidal Behavior in Hospitalized, Suicidal Adolescents. [2023]

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

Smartphone-based safety planning and self-monitoring for suicidal patients: Rationale and study protocol of the CASPAR (Continuous Assessment for Suicide Prevention And Research) study. [2023]