Clinical trial NCT03136094: Suicide in Urban Natives: Detection and Networks to Combat Events
Official title: Collaborative Hub to Reduce the Burden of Suicide Among Urban American Indian and Alaska Native Young Adults
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Suicide Prevention
Keywords: American Indian
Alaska Native
Youth and Young Adult
SBIRT
Lead sponsor: University of Colorado, Denver
Sponsor class: OTHER
Collaborators: name: Washington State University
name: University of New Mexico
name: National Institute of Mental Health (NIMH)
First posted: 2017-05-02
Enrollment: 698
Sex: ALL
Minimum age (years): 18
Maximum age (years): 34
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: The Investigators will conduct a randomized controlled trial to test the effectiveness of an augmented Screening, Brief Intervention, and Referral to Treatment (SBIRT) model that includes sending caring text messages for 12 months after an at-risk patient is identified.
Primary purpose: PREVENTION

Brief summary: This study compares the effectiveness of a program to detect and manage suicide risk among American-Indian and Alaska Native (AI/AN) youth. Half of the participants will receive caring text messages to reduce suicidal thoughts, attempts, and hospitalizations and to increase engagement, social connectedness, and resilience in at-risk youth. The other half will receive usual care that does not include the caring text messages.

Detailed description: The study, "Suicide in Urban Natives: Detection and Networks to Combat Events," builds on Screening, Brief Intervention and Referral to treatment (SBIRT), carried out through the primary care setting, to detect and manage suicide risk. This approach is multilevel, targeting both the healthcare system and the individual, and links screening to existing mobile phone technologies shown to promote resilience and to tap the protective benefits of social connectedness. This Collaborative Hub will conduct a randomized control trial that compares the effectiveness of enhancing these SBIRT programs by sending caring text messages to reduce suicidal ideation, attempts, and hospitalizations, and to increase engagement, social connectedness, and resilience. The Investigators' long-term goal is to disseminate and translate the lessons learned into practical policy, organizational changes, and preventive innovations that optimize patient-centered health outcomes and ultimately reduce or eliminate the dramatic and tragic suicide-related health disparities among urban AI/AN youth and young adults.

Eligibility criteria: Inclusion Criteria:

* Self-identify as American Indian or Alaska Native;
* Screen positive for mild, moderate, or severe risk of suicidality (referred by a clinical provider);
* Have a text-enabled mobile phone;
* Willing to be contacted by text;
* Able to participate voluntarily;
* Speak and read English;
* Cognitively able to independently provide written informed consent

Exclusion Criteria:

* Under age 18
* In danger of imminent self-harm;
* Hospitalized

Primary outcomes:
measure: Change in Suicidal Ideation
timeFrame: Baseline, 6 months, 12 months
measure: Change in Self-Reported Suicide Attempts
timeFrame: Baseline, 6 months, 12 months
measure: Change in Hospitalizations and Behavioral Health Treatment
timeFrame: Baseline, 6 months, 12 months
Secondary outcomes:
measure: Change in Social Connectedness
timeFrame: Baseline, 6 months, 12 months
measure: SBIRT Retention and Uptake of Referral to Therapy
timeFrame: 6 months, 12 months
Other outcomes:
Locations:
city: Albuquerque
country: United States
facility: First Nations Community HealthSource
state: New Mexico
Study officials:
affiliation: University of Colorado, Denver
name: Spero Manson, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Washington
name: Dedra Buchwald, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Herne MA, Bartholomew ML, Weahkee RL. Suicide mortality among American Indians and Alaska Natives, 1999-2009. Am J Public Health. 2014 Jun;104 Suppl 3(Suppl 3):S336-42. doi: 10.2105/AJPH.2014.301929. Epub 2014 Apr 22.
citation: Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, Hegerl U, Lonnqvist J, Malone K, Marusic A, Mehlum L, Patton G, Phillips M, Rutz W, Rihmer Z, Schmidtke A, Shaffer D, Silverman M, Takahashi Y, Varnik A, Wasserman D, Yip P, Hendin H. Suicide prevention strategies: a systematic review. JAMA. 2005 Oct 26;294(16):2064-74. doi: 10.1001/jama.294.16.2064.
citation: Luoma JB, Martin CE, Pearson JL. Contact with mental health and primary care providers before suicide: a review of the evidence. Am J Psychiatry. 2002 Jun;159(6):909-16. doi: 10.1176/appi.ajp.159.6.909.
citation: Beals J, Novins DK, Whitesell NR, Spicer P, Mitchell CM, Manson SM. Prevalence of mental disorders and utilization of mental health services in two American Indian reservation populations: mental health disparities in a national context. Am J Psychiatry. 2005 Sep;162(9):1723-32. doi: 10.1176/appi.ajp.162.9.1723.