Ignite Creation Date:
2024-10-25 @ 7:59 PM
Last Modification Date:
2024-10-26 @ 3:41 PM
Study NCT ID:
NCT06619782
Status:
NOT_YET_RECRUITING
Last Update Posted:
None
First Post:
2024-09-20
Brief Title:
Practice Facilitation to Enhance Implementation of a Pediatric Suicide Prevention Pathway
Sponsor:
None
Organization:
None
Study Overview
Official Title:
Practice Facilitation to Enhance Implementation of a Pediatric Suicide Prevention Pathway
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Suicide in youth is rapidly growing to where it is the second leading cause of death across the United States Use of available tools have shown the potential to boost primary care providers PCPs detection of suicide risk and confidence and knowledge around addressing it however ways that work to address clinic and provider barriers that influence the ongoing implementation of a pathway to manage at-risk patients remain under researched The proposed study will assess the impact of the investigators Facilitated Suicide Prevention program--which provides support to assist practices in integrating screening assessment data analysis and management procedures into routine care through feedback and coaching--on clinic use of the suicide prevention pathway and youth suicide
The project hypothesizes that compared to PCPs in Training Only TO practices those in TOPractice Facilitation PF may rate the care pathway as more able to be carried out and acceptable demonstrate greater use of the pathway components screening risk assessment safety planning lethal means safety counseling referrals and follow-up demonstrate higher levels of use of the pathway suicide prevention skills and report higher levels of confidence putting the care pathway into use
Also we predict that compared to youth who screen positive for suicide risk and are followed by PCPs in TO practices those who screen positive and are followed by PCPs in TOPF practices will be less likely to attempt suicide during the next six months less likely to have suicidal ideation during the next 6 months more likely to see a behavioral health provider during the next 6 months and less likely to be sent to Emergency Departments during the next 6 months
The project hypothesizes that compared to PCPs in Training Only TO practices those in TOPractice Facilitation PF may rate the care pathway as more able to be carried out and acceptable demonstrate greater use of the pathway components screening risk assessment safety planning lethal means safety counseling referrals and follow-up demonstrate higher levels of use of the pathway suicide prevention skills and report higher levels of confidence putting the care pathway into use
Also we predict that compared to youth who screen positive for suicide risk and are followed by PCPs in TO practices those who screen positive and are followed by PCPs in TOPF practices will be less likely to attempt suicide during the next six months less likely to have suicidal ideation during the next 6 months more likely to see a behavioral health provider during the next 6 months and less likely to be sent to Emergency Departments during the next 6 months
Detailed Description:
Suicide is a leading cause of death in youth across the United States Approximately 80 of youth who die by suicide interface with the medical system in the year preceding their death Primary care practices PCPs serving youth are well positioned to detect patients at risk for suicide and intervene and widely accessible toolkits are available for practices to use However effective ways to impact providers skills in actually carrying out a clinical pathway to manage at-risk patients remain under researched Indeed training without applied practice and support is likely not enough to significantly have an effect on these skills in the long term and less likely to improve patient outcomes Practice facilitation is a powerful way to transform clinical practice develop provider skills and improve patient outcomes The investigators train PCPs in the National Institute of Mental Health NIMH youth suicide prevention care pathway and in addition assists them in integrating the pathway into routine care with feedback and support through practice facilitation and data collection However there is limited evidence for the effects of supports such as practice facilitation or coaching on primary care providers use of and skills in suicide risk assessment and management Thus guided by the combined Reach Effectiveness Adoption Implementation Maintenance RE-AIMPractical Robust Implementation and Sustainability PRISM framework this study will compare the impact of practice facilitation added to suicide prevention training based on the NIMH youth suicide prevention care pathway TOPF versus training only TO In this study Pediatric and Family Medicine practices in collaborating practice-based research networks will be assigned to TOPF or to TO Providers in TOPF clinics will receive practice facilitation for 6 months involving monthly individual check-ins which include 1 clinic- and provider-level data review of use data for the five components of the NIMH youth suicide prevention care pathway 2 clinical coaching around implementing the different components of the pathway and 3 coaching in identifying barriers to use and strategies to overcome them At the clinicprovider level the feasibility acceptability effectiveness adoption fidelity use and barriers will be measured At the patient level youth assessed at intermediate or high risk and their family will be followed for 6 months following with data collected on attempted suicides and suicide ideation as well as emergency room and behavioral health provider visits The outcomes will provide preliminary support for a subsequent larger study of the suicide prevention pathway assessing its use impact and sustainability with the goal of promoting broad use in a variety of clinic contexts
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None