Adapting the Suicide Safety Planning Intervention for Delivery to Adolescents in Mozambican Primary Care Settings

NCT05346133 | Completed

• 2 other identifiers: 8129K01MH120258
• Study Type: interventional
• Target: 230
• Locations: 1 country
• Sites: 2

Brief Summary

Globally, suicide is ranked as the second leading cause of death for youth ages 10-24 years, and more than 75% of all deaths by suicide occur in low- and middle-income countries (LMIC). However, the vast majority of adolescents in LMIC do not have access to mental health care, and contextually appropriate strategies for delivering evidence-based interventions for managing suicide risk are needed to expand services to these areas. In the present study, the investigators will adapt and pilot test the Suicide Safety Planning Intervention for Adolescents (SPI-A) delivered by primary care providers in Mozambique, an LMIC in southeastern Africa.

Conditions

Suicide; Adolescent Behavior

Outcome Measures

Primary Outcomes (1)

• Change in suicide risk

  Measuring change in suicide risk as measured by the "Columbia-Suicide Severity Rating Scale" (abbreviated as C-SSRS) at baseline (inclusion) and after 1 month. Scores range from 1-3 with 1 being low risk (the better outcome), 2 being moderate risk, and 3 being high risk (the worse outcome).

  1 month

Secondary Outcomes (1)

• Frequency of Suicide Safety Plan use

  1 month

Other Outcomes (1)

• Frequency of use of specific coping behaviors.

  1 month

Study Arms (1)

SPI-A Adolescents

OTHER

Adolescents with moderate risk will receive the SPI-A intervention from the provider. Adolescents with high risk will be immediately taken to the mental health specialist at the primary care clinic. Following creation of the safety plan, patients are followed-up with at least twice to assess risk and review their plan. Following completion of the pilot, the investigators will interview all included providers as well as 18 adolescents who participated in SPI-A and their caregivers.

Behavioral: Suicide Prevention Intervention for Adolescents

Interventions

Suicide Prevention Intervention for Adolescents BEHAVIORAL

Suicide Safety Planning Intervention (SPI). SPI is a very brief intervention (20-45 minutes) that provides patients with specific strategies to use to decrease the risk of suicidal behavior. SPI begins with psychoeducation about suicide risk, then the clinician and patient collaboratively create a stepwise plan that includes a simple list of individually tailored, concrete coping mechanisms to be enacted during or leading up to a crisis. The steps of the safety plan include: 1) recognizing warning signs of a crisis; 2) employing internal coping strategies; 3) using social contacts and settings to distract from suicidal thoughts; 4) seeking help from family members or close friends; 5) contacting healthcare or emergency services; and 6) reducing access to means. SPI providers work with caregivers to help them monitor warning signs of suicide risk, encourage the use of the safety plan by their adolescent, and reduce access to lethal means in the home.

SPI-A Adolescents

Eligibility Criteria

• Age: 12 Years - 19 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Ages 12-19
• Portuguese-speaking
• Provide informed assent (ages 12-17) or consent (ages 18-19)
• Caregiver provides permission to participate (ages 12-17) Interview Interview

You may not qualify if:

• Having acute illness which requires immediate continued care
• Lacking lack of capacity/cognitive impairment for assent
• Caretaker:
• Parent or guardian of participating adolescent
• Present with adolescent at intervention clinics
• Portuguese-speaking
• Provide permission for adolescent participation Provide informed consent
• Lacking lack of capacity/cognitive impairment for assent
• Provider:
• \- Providers in adolescent services at intervention clinics

Sponsors & Collaborators

• Columbia University: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (2)

Centro de Saude Alto Mae

Maputo, Mozambique

Location

Centro de Saude Bagamoio

Maputo, Mozambique

Location

MeSH Terms

Conditions

Suicide; Adolescent Behavior

Condition Hierarchy (Ancestors)

Self-Injurious Behavior; Behavioral Symptoms; Behavior

Study Officials

• Kate Lovero, PhD

  Columbia University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Sociomedical Sciences

Study Record Dates

• First Submitted: April 13, 2022
• First Posted: April 26, 2022
• Study Start: April 18, 2022
• Primary Completion: October 18, 2022
• Study Completion: December 8, 2022
• Last Updated: February 13, 2023

Record last verified: 2023-02

Data Sharing

• IPD Sharing: Will not share

Locations

MO (2)