360 Participants Needed

Practice Facilitation for Youth Suicide Prevention

NH
VT
Overseen ByVivian Thompson, MPH
Age: Any Age
Sex: Any
Trial Phase: Academic
Sponsor: University of Colorado, Denver
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

What is the purpose of this trial?

Suicide in youth is rapidly growing to where it is the second leading cause of death across the United States. Use of available tools have shown the potential to boost primary care providers' (PCPs) detection of suicide risk and confidence and knowledge around addressing it; however, ways that work to address clinic and provider barriers that influence the ongoing implementation of a pathway to manage at-risk patients remain under researched. The proposed study will assess the impact of the investigators Facilitated Suicide Prevention program--which provides support to assist practices in integrating screening, assessment, data analysis and management procedures into routine care through feedback and coaching--on clinic use of the suicide prevention pathway and youth suicide. The project hypothesizes that compared to PCPs in Training Only (TO) practices, those in TO+Practice Facilitation (PF) may rate the care pathway as more able to be carried out and acceptable; demonstrate greater use of the pathway components (screening, risk assessment, safety planning, lethal means safety counseling, referrals and follow-up); demonstrate higher levels of use of the pathway suicide prevention skills ; and report higher levels of confidence putting the care pathway into use. Also we predict that, compared to youth who screen positive for suicide risk and are followed by PCPs in TO practices, those who screen positive and are followed by PCPs in TO+PF practices will be less likely to attempt suicide during the next six months; less likely to have suicidal ideation during the next 6 months; more likely to see a behavioral health provider during the next 6 months; and less likely to be sent to Emergency Departments during the next 6 months .

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Practice Facilitation for Youth Suicide Prevention?

Research shows that structured implementation of suicide prevention practices, like universal screening and safety planning, can improve outcomes in settings such as juvenile detention centers. Additionally, using implementation science to systematically apply evidence-based practices can enhance the delivery and uptake of suicide prevention interventions.12345

Is Practice Facilitation for Youth Suicide Prevention safe for humans?

There is limited information on the safety of Practice Facilitation for Youth Suicide Prevention, as adverse events (unwanted effects) are often underreported and inconsistently defined in suicide prevention studies. This makes it hard to compare risks and evaluate safety across different studies.678910

How does the treatment Practice Facilitation for Youth Suicide Prevention differ from other treatments for this condition?

Practice Facilitation for Youth Suicide Prevention is unique because it involves training clinicians to use an electronic safety plan template, which is integrated with suicide risk assessment tools, enhancing their ability to implement safety plans effectively. This approach focuses on improving clinician knowledge and self-efficacy, which is different from traditional methods that may not emphasize the use of technology or clinician training as central components.1112131415

Research Team

BJ

Bruno J Anthony, PhD

Principal Investigator

University of Colorado School of Medicine - Anschutz Medical Campus

Eligibility Criteria

This trial is for primary care providers (PCPs) who manage youth at risk of suicide. It aims to integrate a suicide prevention pathway into routine care, enhancing PCP's ability to detect and address suicidality in young patients.

Inclusion Criteria

I am a young person attending a check-up at a participating doctor's office.
Youth receive a positive ASQ screen during their well visit
All staff in enrolled Primary Care practices (e.g., physicians, physician assistants nurses, administrative staff) will be eligible to participate and complete relevant measures.
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Exclusion Criteria

Youth do not receive a positive ASQ screen at well visit.
I am older than 24 years.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Primary care practices are trained in the NIMH youth suicide prevention pathway

6 months
Monthly individual check-ins

Practice Facilitation

Practice facilitation is added to training to provide implementation support for integrating the pathway into routine care

6 months
Monthly individual check-ins

Follow-up

Participants are monitored for safety and effectiveness after training and facilitation

6 months

Treatment Details

Interventions

  • Practice Facilitation
Trial Overview The study tests if adding Practice Facilitation (PF)—which includes support like coaching—to Training Only (TO) in the NIMH Youth Suicide Prevention Pathway improves its adoption by clinics and helps reduce youth suicidality more effectively than training alone.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Practice FacilitationExperimental Treatment2 Interventions
Practice facilitation is added to training in the suicide prevention pathway in primary care to provide implementation support for integrating the pathway into routine care
Group II: Training OnlyActive Control1 Intervention
Primary care practices are trained in the National Institute of Mental Health (NIMH) youth suicide prevention pathway without practice facilitation

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Colorado, Denver

Lead Sponsor

Trials
1,842
Recruited
3,028,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials
3,007
Recruited
2,852,000+

Findings from Research

The comprehensive body system review (BSR) in the Safety Monitoring Uniform Report Form (SMURF) identified 129 additional adverse events (AEs) in pediatric patients, significantly more than the 48 AEs from the general inquiry and 16 from the drug-specific inquiry, highlighting its effectiveness in capturing important safety data.
Parents found the detailed BSR acceptable and satisfactory, while clinicians did not share the same level of acceptance, indicating a potential gap in the perceived utility of detailed adverse event reporting methods in pediatric psychopharmacology.
Comparison of increasingly detailed elicitation methods for the assessment of adverse events in pediatric psychopharmacology.Greenhill, LL., Vitiello, B., Fisher, P., et al.[2007]
The pilot Patient Safety Presentation process, implemented in a psychiatry residency program, significantly improved residents' knowledge and engagement in patient safety practices, as evidenced by pre- and post-presentation surveys involving 32 residents.
All participating residents expressed satisfaction with the presentation, highlighting its effectiveness as a model for enhancing patient safety education in residency programs.
Development and Pilot of a Process for Regularly Sharing Summary Patient Safety Data.Kim, B., Grech, SM., Rembisz, AE., et al.[2023]
The study successfully implemented the Safety Planning Intervention (SPI) for adolescent suicidality in emergency services, showing that training significantly improved providers' attitudes and knowledge about the intervention.
Collaboration with stakeholders and brief training were effective strategies for integrating structured safety planning into pediatric emergency settings, which is crucial for enhancing care for suicidal youths.
Safety Planning Intervention for Adolescents: Provider Attitudes and Response to Training in the Emergency Services Setting.Bettis, AH., Donise, KR., MacPherson, HA., et al.[2022]

References

Harnessing quality improvement and implementation science to support the implementation of suicide prevention practices in juvenile detention. [2023]
Preventing Suicide in Health Systems: How Can Implementation Science Help? [2023]
Improving the application of a practice guideline for the assessment and treatment of suicidal behavior by training the full staff of psychiatric departments via an e-learning supported Train-the-Trainer program: study protocol for a randomized controlled trial. [2023]
Brief cognitive-behavioral treatment for adolescent suicide attempters and their families. [2018]
Facilitators and barriers to implementation of suicide prevention interventions: Scoping review. [2023]
Comparison of increasingly detailed elicitation methods for the assessment of adverse events in pediatric psychopharmacology. [2007]
Development and Pilot of a Process for Regularly Sharing Summary Patient Safety Data. [2023]
Safety Planning Intervention for Adolescents: Provider Attitudes and Response to Training in the Emergency Services Setting. [2022]
Developing a research tool to detect iatrogenic adverse events in psychiatric health care by involving service users and health professionals. [2023]
Variability in the definition and reporting of adverse events in suicide prevention trials: an examination of the issues and a proposed solution. [2022]
Impact of a Virtual Suicide Safety Planning Training on Clinician Knowledge, Self-Efficacy, and Use of Safety Plans in Community Mental Health Clinics. [2023]
12.United Statespubmed.ncbi.nlm.nih.gov
Suicide: issues of prevention, intervention, and facilitation. [2022]
13.United Statespubmed.ncbi.nlm.nih.gov
Youth Voice in Suicide Prevention in Hawai'i. [2023]
14.United Statespubmed.ncbi.nlm.nih.gov
Family processes: Risk, protective and treatment factors for youth at risk for suicide. [2023]
Editorial: Suicide prevention in youth. [2022]
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