Smartphone App Enhanced Facilitation Among Veterans in a Mental Health Inpatient Setting (Project HOPE) (Project HOPE)
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT06378541 |
Recruitment Status :
Not yet recruiting
First Posted : April 22, 2024
Last Update Posted : April 22, 2024
|
Tracking Information | |||||||
---|---|---|---|---|---|---|---|
First Submitted Date ICMJE | April 15, 2024 | ||||||
First Posted Date ICMJE | April 22, 2024 | ||||||
Last Update Posted Date | April 22, 2024 | ||||||
Estimated Study Start Date ICMJE | November 1, 2024 | ||||||
Estimated Primary Completion Date | October 31, 2028 (Final data collection date for primary outcome measure) | ||||||
Current Primary Outcome Measures ICMJE |
Suicide attempts (measured by the Columbia Suicide Severity Rating Scale [C-SSRS] and medical chart review) [ Time Frame: Change from baseline to 6-months ] Suicide attempts will be measured at baseline and follow-ups using using the Colombia Suicide Severity Rating Scale (C-SSRS), administered as a semi-structured interview. We will assess the number and types of suicide attempts (actual, interrupted, and aborted). The definition of suicide attempt for the primary outcome will consist of any actual suicide attempt and/or interrupted suicide attempt during the specified time period according to the C-SSRS. This self-report measure will be supplemented by an Electronic Health Record (EHR) abstraction of participants' VHA records from baseline through 2.5 years after participant ends to collect information regarding suicide attempts.
|
||||||
Original Primary Outcome Measures ICMJE | Same as current | ||||||
Change History | No Changes Posted | ||||||
Current Secondary Outcome Measures ICMJE |
Suicidal ideation (measured by the Scale for Suicidal Ideation [SSI]) [ Time Frame: Baseline, 6-weeks, 3-months, 6-months, 36 months ] The Scale for Suicidal Ideation (SSI) is an interview of suicidal ideation and past suicide attempts, that is part of the PhenX Tool Kit (items range from 0 to 2). Severity of suicidal ideation is associated with a greater risk of suicide. At baseline, the SSI will be administered prior to enrollment as an eligibility screening measure. A score >0 (sum of items 4 + 5) will be used as the cut-off during screening. At baseline and follow-up, the total score (sum of first 19 items) will assess severity of suicidal ideation. This self-report measure will be supplemented by an Electronic Health Record (EHR) abstraction of participants' VHA records from baseline through 2.5 years after participant ends to collect information regarding suicidal ideation.
|
||||||
Original Secondary Outcome Measures ICMJE | Same as current | ||||||
Current Other Pre-specified Outcome Measures |
|
||||||
Original Other Pre-specified Outcome Measures | Same as current | ||||||
Descriptive Information | |||||||
Brief Title ICMJE | Smartphone App Enhanced Facilitation Among Veterans in a Mental Health Inpatient Setting (Project HOPE) | ||||||
Official Title ICMJE | Virtual Hope Box Enhanced Facilitation in High-Risk Suicidal Veterans | ||||||
Brief Summary | This study will test whether a new intervention, Virtual Hope Box Enhanced Facilitation (VHB-EF), reduces suicide risk in Veterans after discharge from inpatient psychiatric hospitalization. Additionally, this study will also conduct interviews with Veterans and healthcare providers to explore barriers and facilitators to future adoption of the VHB-EF intervention in healthcare settings. | ||||||
Detailed Description | Background: Veteran suicide prevention is a top national priority, with Veterans experiencing suicide rates 1.5 times higher than the general population. Suicide rates are especially high among Veterans recently discharged from inpatient mental health units. The Virtual Hope Box (VHB) app, developed by the Department of Defense (DoD), aims to improve access to an intervention used in evidence-based suicide prevention treatments. The VHB app provides users with instant access to suicide prevention resources and coping tools, and is routinely cited as a top evidence-based mental health app, and has been nationally disseminated in the Veterans Health Administration (VHA) and DoD. Despite this, its efficacy in suicide prevention remains under-evidenced, and its reach among high-risk Veterans is limited. To address these concerns, the investigators developed the VHB-EF intervention. VHB-EF has two phases: (1) the in-person inpatient phase involves a single session that assists the Veteran with downloading and using the VHB app, provides personalization and behavioral practice for each component of the app, and addresses strategies to enhance app use; (2) the remote-delivery phase includes two follow-up phone contacts following hospital discharge to monitor suicide risk, review and/or revise VHB content, and support app use and outpatient treatment engagement. The investigators hypothesize that VHB-EF will bolster reasons for living and increase self-efficacy to cope and refrain from suicide attempts, which will in turn reduce suicide attempts. The specific aims of this study are: Aim 1: To evaluate the effects of VHB-EF for reducing suicide attempts (primary outcome). H1: Suicidal Veterans in the VHB-EF arm will be less likely to have a suicide attempt over the 6 months following enrollment compared to those in the EUC condition. The investigators will also examine the effects of VHB-EF on severity of suicidal ideation (secondary outcome). Aim 2: Examine intervention mechanisms by measuring the effects of VHB-EF on potential mediators, 1) reasons for living, and 2) self-efficacy to (a) cope and (b) refrain from suicide attempts. H2: VHB-EF Veterans will report higher levels of reasons for living and self-efficacy, compared to EUC. Exploratory sub-aim: The investigators will test the hypothesis that higher levels of reasons for living and self-efficacy will partially mediate the effect of VHB-EF on suicide attempts over 6-months. Furthermore, the investigators will measure the effects of VHB-EF (vs. EUC) on depressive symptoms and healthcare utilization, and their potential role as mediators of outcomes. Aim 3: To examine the determinants (barriers and facilitators) of VHB-EF adoption to inform future implementation and sustainability of VHB-EF across the VA. The investigators will conduct qualitative interviews with providers and Veterans to determine the feasibility and acceptability of VHB-EF. This will be used to refine the intervention to maximize the impact of future implementation. Methods: This is a 2-site randomized effectiveness-implementation hybrid type I trial that will recruit Veterans (N=928) hospitalized for suicidal crises, test this intervention, and gather data to support future implementation. Outcomes will be assessed at 6 weeks, 3 months, and 6 months post-baseline. The study will also include qualitative interviews with providers and Veterans to assess the feasibility and acceptability of VHB-EF. Significance: This innovative study is the first to test the VHB's impact on suicidal behavior in Veterans during high-risk periods following acute care, addressing a key gap in suicide prevention for this vulnerable group. |
||||||
Study Type ICMJE | Interventional | ||||||
Study Phase ICMJE | Not Applicable | ||||||
Study Design ICMJE | Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Health Services Research |
||||||
Condition ICMJE |
|
||||||
Intervention ICMJE |
|
||||||
Study Arms ICMJE |
|
||||||
Publications * | Not Provided | ||||||
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
|||||||
Recruitment Information | |||||||
Recruitment Status ICMJE | Not yet recruiting | ||||||
Estimated Enrollment ICMJE |
928 | ||||||
Original Estimated Enrollment ICMJE | Same as current | ||||||
Estimated Study Completion Date ICMJE | October 31, 2028 | ||||||
Estimated Primary Completion Date | October 31, 2028 (Final data collection date for primary outcome measure) | ||||||
Eligibility Criteria ICMJE | Inclusion Criteria: Those enrolled in the RCT component of this study must be:
Additional inclusion criteria for the full baseline and follow-up portions of the study include:
Exclusion Criteria: Veterans will be found ineligible for the program if:
|
||||||
Sex/Gender ICMJE |
|
||||||
Ages ICMJE | 18 Years and older (Adult, Older Adult) | ||||||
Accepts Healthy Volunteers ICMJE | No | ||||||
Contacts ICMJE |
|
||||||
Listed Location Countries ICMJE | United States | ||||||
Removed Location Countries | |||||||
Administrative Information | |||||||
NCT Number ICMJE | NCT06378541 | ||||||
Other Study ID Numbers ICMJE | SDR 21-267 | ||||||
Has Data Monitoring Committee | Yes | ||||||
U.S. FDA-regulated Product |
|
||||||
IPD Sharing Statement ICMJE |
|
||||||
Current Responsible Party | VA Office of Research and Development | ||||||
Original Responsible Party | Same as current | ||||||
Current Study Sponsor ICMJE | VA Office of Research and Development | ||||||
Original Study Sponsor ICMJE | Same as current | ||||||
Collaborators ICMJE | Not Provided | ||||||
Investigators ICMJE |
|
||||||
PRS Account | VA Office of Research and Development | ||||||
Verification Date | April 2024 | ||||||
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP |