Correction: mHealth-Supported Delivery of an Evidence-Based Family Home-Visiting Intervention in Sierra Leone: Protocol for a Pilot Randomized Controlled Trial (Preprint)

BACKGROUND Emergency departments (EDs) offer the promise of providing suicide prevention evidence-based practices at the point of need to patients who are acutely suicidal. However, few EDs have adequate time and personnel resources to deliver recommended evidence-based assessment and interventions. We developed Jaspr Health, a tablet-based application that enables the delivery of four evidence-based practices for patients who are acutely suicidal at the point of need to help raise the standard of care in ED settings. OBJECTIVE This study aims to test the feasibility, acceptability, and effectiveness of Jaspr Health among suicidal adults in EDs. METHODS Patients who were acutely suicidal and seeking psychiatric crisis services participated in a pilot randomized controlled trial while in the ED. Participants were assigned randomly to Jaspr Health (n=14) or care-as-usual (CAU) control (n=17). RESULTS Conditions differed significantly at baseline on age, but not on other demographic variables or baseline measures. On average, participants had been in the ED for 17 hours prior to enrolling in the research study. Over their lifetimes, 74% of the sample had made a suicide attempt (M=3.4; SD=6.4) and 61% had engaged in non-suicidal self-injurious behaviors, with an average rate of 8.8 times in the past three months. All established feasibility and acceptability criterion were met: no adverse events occurred, participants’ app usage was high, Jaspr Health app satisfaction ratings were high, and all Jaspr Health participants recommended its use for other suicidal ED patients. Comparisons between study conditions further support the application’s effectiveness: Jaspr Health participants reported a statistically significant increase in receiving four evidence-based suicide prevention interventions. Additionally, significant decreases in distress and agitation along with significant increases in learning to cope more effectively with current and future suicidal thoughts were observed among the Jaspr Health participants. Finally, in comparison to CAU, Jaspr Health participants provided higher satisfaction ratings of their overall ED experience. CONCLUSIONS Even with limited statistical power, results showed Jaspr Health to be feasible, acceptable, and clinically effective for use with ED patients who are acutely suicidal and seeking ED-based psychiatric crisis services. CLINICALTRIAL ClinicalTrials.gov NCT03584386

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Using a Tablet-based App to Deliver Evidence-Based Practices for Suicidal Patients in the Emergency Department: A Pilot Randomized Controlled Trial (Preprint)

JMIR Mental Health ◽

10.2196/23022 ◽

2020 ◽

Author(s):

Linda A. Dimeff ◽

David A. Jobes ◽

Kelly Koerner ◽

Nadia Kako ◽

Topher Jerome ◽

...

Keyword(s):

Emergency Department ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Evidence Based ◽

Evidence Based Practices ◽

Randomized Controlled ◽

Suicidal Patients ◽

Pilot Randomized Controlled Trial

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An evidence-based walking program among older people with knee osteoarthritis: the PEP (participant exercise preference) pilot randomized controlled trial

Clinical Rheumatology ◽

10.1007/s10067-017-3606-9 ◽

2017 ◽

Vol 36 (7) ◽

pp. 1607-1616 ◽

Cited By ~ 9

Author(s):

Laurianne Loew ◽

Lucie Brosseau ◽

Glen P. Kenny ◽

Natalie Durand-Bush ◽

Stéphane Poitras ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Older People ◽

Knee Osteoarthritis ◽

Controlled Trial ◽

Evidence Based ◽

Randomized Controlled ◽

Walking Program ◽

Exercise Preference ◽

Pilot Randomized Controlled Trial

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mHealth Supported Delivery of an Evidence-based Family Home Visiting Intervention in Sierra Leone: A Pilot Randomized Controlled Trial Study Protocol (Preprint)

10.2196/preprints.25443 ◽

2020 ◽

Author(s):

Alethea Desrosiers ◽

Carolyn Schafer ◽

Rebecca Esliker ◽

Musu Jambai ◽

Theresa Betancourt

Keyword(s):

Mental Health ◽

Emotion Regulation ◽

Sierra Leone ◽

Home Visiting ◽

Early Childhood Development ◽

Controlled Trial ◽

Childhood Development ◽

Evidence Based ◽

Caregiver Mental Health ◽

Pilot Randomized Controlled Trial

BACKGROUND Past trauma and exposure to violence has been related to poor emotion regulation and household violence, which can have persistent mental health effects across generations. The Family Strengthening Intervention for Early Childhood Development (FSI-ECD/called Sugira Muryango in Rwanda) is an evidence-based behavioral home-visiting intervention to promote caregiver mental health, positive parenting practices, and early childhood development among families facing adversity. In Sierra Leone and other LMICS, mHealth technology has the potential to improve health care delivery and health outcomes. OBJECTIVE This study aims to: (a) apply user-centered design to develop and test mHealth tools to improve supervision and fidelity monitoring of community health workers (CHWs) delivering the FSI-ECD and (b) conduct a pilot randomized controlled trial of the FSI-ECD to assess feasibility, acceptability, and preliminary effects on caregiver mental health, emotion regulation, caregiving behaviors, and family violence in high-risk families with children aged 6-36 months in comparison with control families receiving standard care. METHODS We will recruit and enroll CHWs, supervisors and families with a child aged 6-36 months from community health clinics in Sierra Leone. CHWs and supervisors will participate in one problem-analysis focus group and two user interface/user experience (UI/UX) cycles to provide feedback on mHealth tool prototypes. Families will be randomized to mHealth supported FSI-ECD or standard maternal and child health services. We will collect quantitative data on caregiver mental health, emotion regulation, caregiving behaviors, and family functioning at baseline, post-intervention and 3-month follow-up. We will use a mixed-methods approach to explore feasibility and acceptability of mHealth tools and the FSI-ECD. Mixed effects linear modeling will assess FSI-ECD effects on caregiver outcomes. Cost-effectiveness analysis will estimate costs across FSI-ECD vs standard care. RESULTS Funding for this study was received from the National Institute of Mental Health on August 17, 2020. Institutional Review Board approval was received September 4, 2020. Data collection is projected to begin December 15 2020. CONCLUSIONS This study will provide important data on the feasibility, acceptability and preliminary efficacy of mHealth-supported delivery of an evidence-based family home visiting intervention in a post-conflict, LMIC. CLINICALTRIAL Clinical trial registration: NCT04481399; registered July 22, 2020.

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