Virtual Hope Box for Suicide Prevention

(Project HOPE Trial)

Recruiting at 1 trial location

Overseen By Courtney L Bagge, PhD MA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Non-English speakers, Prisoners, Cognitive deficits, others

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

Compensation: Varies

Number of Visits: 3

928 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test a new method called Virtual Hope Box Enhanced Facilitation (VHB-EF) to help reduce the risk of suicide among Veterans after they leave a psychiatric hospital. VHB-EF includes a one-on-one session to assist Veterans in downloading and using a supportive app, followed by phone check-ins to encourage ongoing use and support. The trial will compare this approach to standard care, which involves only a review of local mental health resources. It seeks Veterans who have recently faced a suicidal crisis, have not used the VHB app in the past year, and own a smartphone. As an unphased trial, this study offers Veterans a unique opportunity to contribute to innovative mental health solutions.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What prior data suggests that the Virtual Hope Box Enhanced Facilitation is safe for Veterans?

Research has shown that the Virtual Hope Box (VHB) app helps Veterans manage stress and improve coping skills. The Department of Defense and the VA created the app to support those at risk of suicide. Users have not reported any major negative effects from using the VHB app.

The app is generally well-received, with studies reporting no serious problems. It serves as a helpful tool for Veterans to access coping resources on their smartphones. This study involves an enhanced version of the app, and its safety is expected to align with the original version.

Since the study phase isn't specified, it likely focuses on the app's usability and impact rather than early-stage safety. The app's development by respected organizations also suggests it is safe for use. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Virtual Hope Box Enhanced Facilitation (VHB-EF) because it offers a personalized and tech-driven approach to suicide prevention. Unlike traditional treatments that might rely on medication or therapy sessions, VHB-EF uses a smartphone app to provide immediate support and resources tailored to each individual. This method not only empowers users by integrating mental health tools directly into their daily lives but also extends support beyond the hospital setting through follow-up phone contacts. This makes VHB-EF a potentially powerful tool for continuous engagement and risk monitoring, especially for Veterans transitioning from inpatient care.

What evidence suggests that the Virtual Hope Box Enhanced Facilitation is effective for reducing suicide risk in Veterans?

Research shows that the Virtual Hope Box (VHB) app helps Veterans manage their emotions during difficult times. In this trial, some participants will receive the Virtual Hope Box Enhanced Facilitation (VHB-EF), which includes personalized support and follow-up to enhance app use. Users of the app reported feeling better able to cope, experiencing fewer thoughts about suicide, and finding stronger reasons to live. The app is designed for use during stress or crisis, offering tools to calm and focus the mind. It provides a personalized experience, giving users easy access to reminders of what is most important to them. While more studies are underway, early results suggest it can be a useful tool in reducing suicide risk among Veterans. ^{1 2 4 6 7}

Who Is on the Research Team?

Courtney L Bagge, PhD MA

Principal Investigator

VA Ann Arbor Healthcare System, Ann Arbor, MI

Are You a Good Fit for This Trial?

This trial is for Veterans who have experienced suicidal thoughts or behaviors and are being discharged from inpatient psychiatric care. It's designed to see if a new smartphone app can help them after they leave the hospital.

Inclusion Criteria

A score of 3 on the Callahan 6-item cognitive screening

Own a smartphone to download the VHB app

I am a veteran over 18, admitted for a recent suicidal crisis and am medically stable.

Exclusion Criteria

Do not own a smartphone

Veterans who do not understand English

Prisoners

Timeline for a Trial Participant

Inpatient Phase

Participants receive a single, one-on-one, 60-minute session to download and personalize the VHB app, and review mental health resources.

1 session

1 visit (in-person)

Remote-Delivery Phase

Two follow-up phone contacts within 14 days post-discharge to monitor suicide risk, review VHB content, and support app use.

2 weeks

2 visits (virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments at 6 weeks, 3 months, and 6 months.

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Enhanced Usual Care
• Virtual Hope Box Enhanced Facilitation

Trial Overview The study is testing 'Virtual Hope Box Enhanced Facilitation' (VHB-EF), which is an app-based intervention aimed at reducing suicide risk, against 'Enhanced Usual Care'. The effectiveness of VHB-EF will be measured by its impact on participants post-discharge.

How Is the Trial Designed?

Group I: Virtual Hope Box Enhanced Facilitation (VHB-EF) Experimental Treatment 1 Intervention

The VHB-EF intervention has two phases: (1) The in-person inpatient phase involves a single, one-on-one, 60-minute session delivered by the study interventionist prior to hospital discharge. During this session, the interventionist will obtain access to the participant's personal phone and assist them in downloading the VHB app. The interventionist will provide education about the app and personalized behavioral practice for each component of the app. They will also address strategies to enhance app use. In addition, participants will review a list of Veteran mental health resources, community services, Veteran service organizations, and other Veteran social support services available to Veterans in the area. (2) The remote-delivery phase builds on the work begun in the hospital via 2 follow-up phone contacts within 14 days following discharge, during which the study interventionist will monitor risk, review/revise VHB content, and support app use and outpatient treatment engagement.

Group II: Enhanced Usual Care (EUC) Active Control 1 Intervention

The EUC condition will involve a one-on-one, 30-minute session delivered by the study interventionist prior to hospital discharge, during which the interventionist will review Veteran mental health resources, community services, Veteran service organizations, and other Veteran social support services available to Veterans in the area. The EUC session will remain focused only on reviewing the standardized list of Veteran and community services; no counseling will be provided, and the list provided by the study interventionist does not include non-services (i.e., does not list any smartphone applications, including the VHB app).

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Published Research Related to This Trial

The Virtual Hope Box (VHB) app was found to be more regularly used and preferred by high-risk patients and their clinicians compared to a traditional hope box, indicating its potential effectiveness in helping patients cope with negative thoughts and stress.

Patients reported that the VHB was beneficial, easy to set up, and expressed a strong likelihood of continued use and recommendation to others, suggesting its practicality as a therapeutic tool.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Virtual Hope Box smartphone app as an accessory to therapy: proof-of-concept in a clinical sample of veterans. Bush, NE., Dobscha, SK., Crumpton, R., et al.[2022]

The Safety Planning Intervention (SPI) is effective in reducing suicidal ideation and behavior, as well as improving depression and treatment engagement among adults experiencing suicide-related distress, based on a systematic review of 26 studies.

The SPI is adaptable and can be delivered in various formats (in-person or online) and as a standalone or combined intervention, making it a flexible tool in suicide prevention practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of the Safety Planning Intervention for Adults Experiencing Suicide-Related Distress: A Systematic Review. Ferguson, M., Rhodes, K., Loughhead, M., et al.[2022]

Emphasizing early intervention and ongoing low-intensity contact with individuals at risk of suicide can be more effective than solely focusing on those deemed 'highest risk', suggesting a shift in treatment strategy.

The use of advanced interactive computer programs can enhance screening and training for healthcare providers, improving access to mental health services and continuity of care for suicidal individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicide prevention in a treatment setting. Litman, RE.[2022]

The telehealth suicide safety planning intervention (SPI) was found to be highly acceptable and feasible among high-risk Veterans, with participants rating it positively on acceptability (M=17.50), appropriateness (M=17.25), and feasibility (M=18) on a scale of 1 to 20.

Participants reported enhanced suicidal disclosure and improved management of urges, indicating that the SPI effectively supported their mental health needs while also addressing barriers like privacy and technology issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Qualitative Study of Telehealth Delivery of Suicide-Specific Group Treatment "Project Life Force". Patel, SR., Sullivan, SR., Mitchell, EL., et al.[2023]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06378541

Smartphone App Enhanced Facilitation Among Veterans in ... This study will test whether a novel intervention, Virtual Hope Box Enhanced Facilitation (VHB-EF), reduces suicide risk in Veterans after discharge from ...

2. reporter.nih.gov reporter.nih.gov/search/ltSyp-hVqU-NNgpwHm1j1g/project-details/10635900

Project Details The Virtual Hope Box (VHB), a mobile phone application (app) developed by the Department of Defense (DoD) and VA, allows patients to access reasons for living ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10922839/

Frequency and predictors of virtual hope box use in ... The Virtual Hope Box (VHB) is a smartphone application designed to support emotion regulation when one is distressed, in a crisis, or experiencing suicidal ...

4. hsrd.research.va.gov hsrd.research.va.gov/research/citations/pubbriefs/articles.cfm?RecordID=833

“Virtual Hope Box” Smartphone App Helps Veterans Regulate ... Self-reported primary outcomes included coping, suicidal ideation, and reasons for living. FINDINGS: VHB users reported significantly greater ability to cope ...

5. withpower.com withpower.com/trial/phase-suicide-10-2024-d8523

Virtual Hope Box for Suicide Prevention (Project HOPE Trial) This study will test whether a novel intervention, Virtual Hope Box Enhanced Facilitation (VHB-EF), reduces suicide risk in Veterans after discharge from ...

6. hsrd.research.va.gov hsrd.research.va.gov/research/citations/pubbriefs/articles.cfm?RecordID=651

“Virtual” Hope Box Smartphone App Delivers Patient-Tailored ... "Virtual" Hope Box Smartphone App Delivers Patient-Tailored Coping Tools to Help Veterans at Risk for Suicide. BACKGROUND: Cognitive-behavioral-based therapies ...

7. psychiatryonline.org psychiatryonline.org/doi/10.1176/appi.ps.201600283

A Virtual Hope Box: Randomized Controlled Trial of ... The purpose of this study was to assess the impact of the Virtual Hope Box (VHB), a smartphone app to improve stress coping skills, ...