Clinical trial NCT06364332: Chatsafe Netherlands: Improving Safe Suicide Communication for Young People on Social Media
Official title: Testing the Impact of #ChatsafeNL in a Randomized Controlled Trial: Does a Social Media Intervention Improve Dutch Young People's Safe Online Communication About Suicide?
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Suicide Prevention
Communication
Social Media
Keywords: Suicide prevention
Suicidal Ideation
Communication
Social Media
Lead sponsor: 113 Suicide Prevention
Sponsor class: OTHER
Collaborators: name: Orygen
name: Mind
First posted: 2024-04-15
Enrollment: 400
Sex: ALL
Minimum age (years): 16
Maximum age (years): 25
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Participants are randomized to the intervention or the control group using block randomization with varying block sizes (block sizes vary from 2 to 16). The distribution key will be 1:1. The randomization schedule is computer generated by a researcher who will not be part of the analysing researchers.
Primary purpose: PREVENTION

Brief summary: Suicide is the leading cause of death among young people (YP) aged 10 to 25 years in the Netherlands. In addition, YP report high rates of suicidal ideation (16%). While suicidal behavior is a complex phenomenon with many factors and causes, the role of social media is becoming more prominent, especially for YP. Social media has been shown to be a source where YP can find support, but it's also a place where suicidal behavior is glorified or normalized, which can be triggering or harmful to other social media consumers.

The #Chatsafe guidelines were developed by Orygen Australia to better equip young people to communicate safely about suicide on social media. These guidelines are supported by a social media campaign to make the content of the guidelines more accessible to them. The #Chatsafe intervention consists of both the guidelines and the social media campaign. A small-scale Australian feasibility study showed promising results in terms of the acceptance and safety of the campaign, and safety regarding communicating about suicide on social media platforms. Currently, in Australia it is tested to what extent these results hold up in a Randomized Controlled Trial (RCT) (Robinson et al., 2023).

With funding from the Dutch National Agenda for Suicide Prevention, a contextualized replication study is conducted. The aim of this study is to determine whether the #Chatsafe intervention has an effect on the way in which Dutch YP communicate online about suicide.

Detailed description: The #Chatsafe guidelines were developed by Orygen to better equip YP to communicate safely about suicide on social media. These guidelines are supported by a national social media campaign to make the content of the guidelines more accessible to the target group. The #Chatsafe intervention consists of both the guidelines and a social media campaign. A small-scale Australian feasibility study showed promising results in terms of acceptance and safety of the campaign, as well as the willingness of young people to intervene against suicide, their perceived self-efficacy, confidence, and safety regarding communicating about suicide on social media platforms. To test whether the effects hold up in a controlled setting, a Randomized Controlled Trial (RCT) is conducted.

With funding from the Dutch National Agenda for Suicide Prevention, commissioned by 113 Suicide Prevention, the #Chatsafe campaign is being translated to fit the Dutch context through a co-design process involving end users. To investigate whether this campaign has the intended effect in the Netherlands, a contextualized replication study into the efficacy of ChatsafeNL (Chatsafe Netherlands) is conducted in a controlled setting. The aim of the research is to determine whether the #ChatsafeNL intervention affects how YP, both with and without suicidal ideation, communicate online about suicide. A group receiving #ChatsafeNL content (intervention group) will be compared with a group who received content about sexual health and wellbeing (control group).

In the current study, the efficacy of the #ChatsafeNL intervention is tested in an RCT. The intervention condition (#ChatsafeNL social media intervention) is compared with a control intervention (sexual health campaign). The intervention phase lasts 8 weeks. Participants will be recruited over a period of 6-12 months.

Participants are asked to complete a self-report questionnaire at three different times, namely prior to the intervention (baseline, T1), immediately after the 8-week intervention (T2) and 4 weeks post-intervention (T3). During the intervention period, participants receive campaign content every week for 8 weeks. They are offered a short questionnaire to monitor safety and assess the evaluation of the content.

Initially, the campaign is developed for Instagram. This may expand to other social media platforms later on.

Eligibility criteria: Inclusion Criteria:

* age between 16-25 years,
* living in the Netherlands and speaking Dutch,
* see themselves as active social media user,
* is willing to share mobile phone number with the research team.

Exclusion Criteria:

None, if participants meet the inclusion criteria, they can principally participate in the study; having suicidal ideation is not a reason for exclusion. An extensive safety procedure is drawn up, which describes how the safety of the participants is monitored.

Primary outcomes:
measure: Safe communication about suicide online
timeFrame: Before, immediately after intervention and at 4 week follow up
Secondary outcomes:
measure: Confidence when communicating about suicide online
timeFrame: Before, immediately after intervention and at 4 week follow up
measure: Willingness to intervene against suicide online
timeFrame: Before, immediately after intervention and at 4 week follow up
measure: Self-efficacy online
timeFrame: Before, immediately after intervention and at 4 week follow up
measure: Safety of the #ChatsafeNL materials
timeFrame: Before, immediately after intervention and at 4 week follow up
measure: Acceptability of the #ChatsafeNL intervention
timeFrame: Before, immediately after intervention and at 4 week follow up
measure: Safety of the #ChatsafeNL intervention
timeFrame: Before, immediately after intervention and at 4 week follow up
Other outcomes:
Locations:
city: Amsterdam
country: Netherlands
facility: 113 Suicide Prevention
state: Noord Holland
Study officials:
affiliation: 113 Suicide Prevention
name: Saskia Mérelle, dr
role: PRINCIPAL_INVESTIGATOR
References:
citation: Robinson J, La Sala L, Cooper C, Spittal M, Rice S, Lamblin M, Brown E, Nolan H, Battersby-Coulter R, Rajaram G, Thorn P, Pirkis J, May-Finlay S, Silenzio V, Skehan J, Krysinska K, Bellairs-Walsh I. Testing the Impact of the #chatsafe Intervention on Young People's Ability to Communicate Safely About Suicide on Social Media: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2023 Feb 17;12:e44300. doi: 10.2196/44300.
citation: La Sala L, Pirkis J, Cooper C, Hill NTM, Lamblin M, Rajaram G, Rice S, Teh Z, Thorn P, Zahan R, Robinson J. Acceptability and Potential Impact of the #chatsafe Suicide Postvention Response Among Young People Who Have Been Exposed to Suicide: Pilot Study. JMIR Hum Factors. 2023 May 19;10:e44535. doi: 10.2196/44535.
citation: La Sala L, Teh Z, Lamblin M, Rajaram G, Rice S, Hill NTM, Thorn P, Krysinska K, Robinson J. Can a social media intervention improve online communication about suicide? A feasibility study examining the acceptability and potential impact of the #chatsafe campaign. PLoS One. 2021 Jun 15;16(6):e0253278. doi: 10.1371/journal.pone.0253278. eCollection 2021.