Are JITAIs acceptable for use in suicide prevention?
Research type
Research Study
Full title
Are Just-in-Time-Adaptive-Interventions (JITAIs) acceptable for use in suicide prevention? Developing a framework to inform the advancement of a JITAI for suicide prevention in a UK male population
IRAS ID
320430
Contact name
Michael Baliousis
Contact email
Sponsor organisation
University of Lincoln
Duration of Study in the UK
1 years, 1 months, 21 days
Research summary
Summary of Research
Primary aim: To evaluate male participants attitudes towards a hypothetical suicide prevention app, using the Theoretical Framework of Acceptability.
The hypothetical suicide prevention app is based on a Just-in-time-adaptive-intervention (JITAI). A JITAI app aims to provide an individual with the right support at the right time, and only when needed, based on dynamic assessments of an individual's internal state and context.
Males in the UK are at the highest risk of ending their lives by suicide, and there is a gap in knowledge regarding effective suicide prevention and the effective use of a JITAI as an intervention methodology.
The study will use two main stakeholders; males who have previously been at risk of suicide and mental health professionals who would be offering the use of the intervention in individuals at risk of suicide. Males with lived experience will be recruited from Lincolnshire Partnership Foundation Trust (LPFT) and Rotherham Doncaster and South Humber NHS trust (RDaSH). Individuals must be supported by a mental health team to manage risk to self and must not have any active suicidal ideation or intent prior to engaging in the study, this will be assessed using a self-report risk assessment questionnaire during the consenting process. Professional stakeholders will be recruited from LPFT and RDaSH.
An acceptability study is one of the early stages of the development of a complex intervention as per the the UK Medical Research Council guidance, to guide the decision on whether to proceed with the development of a complex intervention. A qualitative methodology will be utilised to understand the acceptability of the intervention, via one-to-one interviews. One-to-one interviews are expected to last no more than 90 minutes, however, given the semi-structured interview methodology there is no set time frame in order to provide participants with time to fully answer questions and provide their opinion.
Summary of Results
Suicide is one of the leading causes of death worldwide and the male population accounts for the largest proportion of deaths by suicide. Despite high rates of male suicide, males are less likely to seek help for their mental health. Suicide prevention interventions have polarised evidence regarding efficacy and are argued to be incompatible with the needs of males at risk of suicide. Male-specific suicide prevention interventions have been found to improve help-seeking and led to recommendations for mobile health (mHealth) interventions. Just-in-time-adaptive-interventions (JITAIs) are mHealth interventions designed to provide individuals with the right support, at the right time, and only when needed. Coppersmith et al. (2022) developed a protocol for the use of a JITAI in suicide prevention.
Given the high rates of death by suicide in the male population, the polarised evidence regarding the efficacy of current suicide prevention interventions, and recommendations for the development of mHealth interventions, the current study aimed to determine if a JITAI for suicide prevention would be acceptable to mental health professionals. Improved acceptability of an intervention by mental health professionals has been found to improve clinical outcomes.
Method
Semi-structured interviews were held with mental health professionals to determine the acceptability of a hypothetical JITAI for suicide prevention based on the Coppersmith et al. (2022) protocol. The Theoretical Framework of Acceptability (TFA, Sekhon et al., 2017) comprises seven constructs argued to represent the multi-faceted construct of acceptability of healthcare interventions. Deductive content analysis based on the constructs in the TFA was utilised to analyse the data.Results
A total of 20 mental health professionals were recruited across two UK NHS sites. A matrix was developed based on the TFA constructs and provided a framework for the development of a JITAI for suicide prevention. The study highlighted a consensus that a JITAI for suicide prevention would be acceptable for some individuals, however, participants described several concerns and made recommendations to ensure safe implementation.Conclusions
The study highlights the potential positive effects of a JITAI for suicide prevention that is acceptable to professionals working with some individuals at risk of suicide and should therefore be considered as a starting point for further research. Further research should be conducted to understand service user views of a JITAI for suicide prevention, particularly focusing on the nuances of suicidality and how this may impact engagement and overall efficacy. The TFA provided a useful framework for analysis and the development of a framework for future JITAI advancement.REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
22/NW/0395
Date of REC Opinion
14 Mar 2023
REC opinion
Further Information Favourable Opinion