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The SPARC Trial: comparing safety planning plus structured follow-up from a suicide prevention hotline (SP+SFU) to usual care (safety planning without follow-up) for suicide prevention among adult and adolescent recipients of care in emergency departments and primary care clinics
Investigator (PI): Radin, Anna K
Performing Organization (PO): (Current): St. Luke's Health System / (208) 381-2222
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2020
Final Year: 2024
Record Source/Award ID: PCORI/IHS-2018C3-14695
Funding: Total Award Amount: $3,850,250
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Suicide is a leading cause of death in the United States, and one person loses their life to suicide every 12 minutes. Idaho has one of the highest suicide rates in the country. Half of people who die of suicide visit their health care provider within a month of their death, yet there is a lot we still do not understand about the best way for providers to help prevent suicide. This research will compare two evidence-based approaches to prevent suicide: (1) safety planning plus follow-up support from a suicide prevention hotline, versus (2) safety planning alone. Safety planning involves suicidal patients working with their providers to develop an action plan that they can use if they have suicidal thoughts in the future. The follow-up intervention will include a phone call from a suicide prevention hotline specialist and a series of supportive text messages sent to the patient every week or two for about a year. Our goal is to determine which approach works best to reduce the risk of suicide, improve the patient's quality of life, and ensure they are getting appropriate mental health treatment. We also want to see if the effect of these interventions is different for adolescents compared to adults. Our research team includes researchers, doctors, and other health care providers at St. Luke's Health System in Idaho; researchers at the University of Washington, the University of Idaho, and the University of Pennsylvania; community partners at the Idaho Suicide Prevention Hotline, Empower Idaho, and the Idaho Federation of Families for Children's Mental Health; and people with lived experience with suicide. People who have experienced suicide themselves--either because they attempted suicide and survived, or because they are close to someone who lost their life to suicide--will be key partners in this research. Every few months, we will meet with a group of people who have experienced suicide to be sure that their perspective is reflected in the research study. We will ask for their input on things like the study enrollment process, and how best to keep research participants engaged in the study for a whole year. We are also working closely with a team of doctors, nurses, social workers, and other health care providers to ensure that the study we design works for them too. Suicide is preventable. Our goal with this research is to determine the best way for health systems to help their patients who may be struggling with suicidal thoughts to live happier, healthier lives.
Abstract Archived: Lay Abstract: What is the research about? Half of people who die from suicide have contact with a hospital or health system within a month of their death. In this study, the research team is comparing two ways that clinicians can help prevent suicide. The first way is safety planning. In safety planning, clinicians help patients create action plans to use if they have suicidal thoughts. The second way is safety planning with follow-up support from a suicide prevention hotline. Who can this research help? Results may help health systems when considering approaches to prevent suicide. What is the research team doing? The research team is assigning 8 emergency departments, or EDs, and 22 primary care clinics by chance to provide either safety planning or safety planning with follow-up support. The EDs and clinics are part of a health system in Idaho. The team is recruiting 1,460 adults and adolescents who report having low, moderate, or high risk for suicide to take part in the study. In safety planning, patients and their healthcare providers work together to spot warning signs of suicide. They also work to identify Coping strategies People and social settings that can be used for support and distraction Professional help Access to anything a patient may use to harm themselves In safety planning plus follow-up support, support from a suicide prevention hotline includes at least one phone call from a suicide prevention specialist within 24 hours of discharge. Patients also receive 25 supportive text messages over the course of a year. The research team is following up with patients 6 and 12 months after they enroll in the study to see if they have suicidal thoughts or behaviors. The team is also asking patients about their quality of life and looking to see if they go back to the ED or clinic for care related to suicide or use outpatient mental health services.  The research team is comparing these outcomes between the safety planning and safety planning plus follow-up support groups. The team also wants to see if outcomes differ for adolescents compared with adults. Finally, the team is asking study participants and clinicians how well safety planning or safety planning plus follow-up works for them. Patients who have attempted suicide or who are close to someone who has died from suicide are giving input on the study. Healthcare providers, suicide prevention hotline specialists, and mental health providers are also helping to develop and carry out the study. Research methods at a glance. Design. Randomized controlled trial. Population 1,460 patients (960 adults and 500 teens) who screened positive for suicide risk in EDs and primary care clinics. Interventions/ Comparators. Safety planning; Safety planning plus follow-up support. Outcomes. Primary: suicidal ideation and behavior. Secondary: quality of life, return to care for suicidality, uptake of outpatient mental health services. Timeframe. 12-month follow-up for primary outcome.

MeSH Terms:
  • Adolescent
  • Adult
  • Emergency Medicine /*organization & administration
  • Evidence-Based Medicine /methods
  • * Hotlines
  • Humans
  • Idaho
  • Interdisciplinary Communication
  • Outcome Assessment (Health Care)
  • Patient Care Team
  • Patient Participation
  • Patient Safety
  • Pennsylvania
  • Primary Care /*organization & administration
  • Suicide /*prevention & control
  • Washington
Country: United States
State: Idaho
Zip Code: 83712
UI: 20202800
Project Status: Ongoing
Record History: ('Alternate Title: Comparing two ways for healthcare providers to intervene to prevent suicide among adults and adolescents',)