Systems Aligning for Equity (SAFE) Spaces

Study Overview
=================
Brief Summary
-----------------
The goal of this 2-arm cluster randomized clinical trial is to test whether an evidence-based staff training and coaching model specifically designed as a response to legal system-involved youths' and frontline staff's mental health needs can improve the safety and suicide outcomes, mental health challenges, and wellness and facility climate for youth and staff in facilities assigned to the intervention condition. Staff in facilities assigned to the intervention are eligible to receive evidence-based programming in suicide detection and prevention (Shield of Care; SOC) and wellness skill-building (Skills for Life) through training and personalized coaching. Multiple training sessions will be offered to small groups of staff in-person in residential facilities and paired with personalized in-person and virtual coaching. Staff and youth in all facilities will be asked to complete periodic surveys assessing experiences in the facility, suicide and safety knowledge and risk, and their mental health and wellness. Researchers will compare outcomes of staff in youth in facilities assigned to the intervention compared to facilities in the training-as-usual condition.

Official Title
-----------------
Experimental Evaluation of a Multi-site Suicide Intervention for Youth During and After Residential Placement

Conditions
-----------------
Suicide, Mental Disorder, Mental Health, Burnout, Professional, Self Harm

Intervention / Treatment
-----------------
* Behavioral: SAFE Spaces training and coaching


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Placement in in ACS-run or contracted residential facilities enrolled in the study during the first 2 years of the intervention period Proficiency in English Exclusion Criteria: Not placed in an ACS run-or contracted facility enrolled in the study during the study period Lack of proficiency in English.
Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: SAFE Spaces training and coaching<br>Staff in facilities assigned to this arm are offered the SAFE Spaces training and coaching model. | Behavioral: SAFE Spaces training and coaching<br>* Staff in facilities assigned to the intervention are eligible to receive evidence-based programming in suicide detection and prevention (Shield of Care; SOC) and wellness skill-building (Skills for Life) through training and personalized coaching. Multiple training sessions will be offered to small groups of staff in-person in residential facilities and paired with personalized in-person and virtual coaching.<br>|
| No Intervention: Training as Usual<br>Staff in facilities assigned to this arm receive training as usual. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Decreases in Suicidal Ideation Questionnaire (Davis, 1992) and suicide subscale of Massachusetts Youth Screening Instrument (Grisso et al., 2001) | Change in suicide ideation, thoughts, and behaviors | 1 year | 
| Decreases on Self-Injurious Thoughts and Behaviors Interview (Nock et al., 2007) | Change in self-harm thoughts and behaviors | 1 year | 
| Decreases on internalizing and externalizing subscales of Massachusetts Youth Screening Instrument (Grisso et al., 2001) | Change in mental health correlates of suicide | 1 year | 
| Decreased burnout and increased job efficacy on the Professional Quality of Life measure (Stramm, 2016) and the Maslach Burnout Inventory | Change in staff burnout and job efficacy | 1 year | 
| Change in responses on the Inventory of Depression and Anxiety Symptoms (Watson et al., 2007) | Change in staff mental health | 1 year | 
| Increased suicide knowledge and response skills from Tennessee's state-wide gatekeeper training (Schut & Lockman, 2013) | Change in suicide knowledge and response skills | 1 year | 
| Increased self-harm knowledge response skills from Tennessee's state-wide gatekeeper training (Schut & Lockman, 2013) | Change in self-harm knowledge and response skills | 1 year |