Accepted for/Published in: JMIR Mental Health
Date Submitted: Sep 19, 2019
Date Accepted: Feb 21, 2020
Implementation Determinants and Outcomes for a Technology Enabled Service Targeting Suicide Risk in High Schools
ABSTRACT
Background:
Background:
Technology enabled services (TES), which integrate human service and digital components, are increasingly popular strategies to increase the reach and impact of mental health interventions, but large-scale implementation of TES has lagged behind their potential.
Objective:
Objective:
This research applied a mixed qualitative and quantitative approach to gather input from multiple key user groups (students and educators) and understand the factors that support successful implementation (implementation determinants) and implementation outcomes for a TES for universal screening, ongoing monitoring, and support for suicide risk management in the school setting.
Methods:
Methods:
Students (N=111) in 9th to 12th grade completed measures regarding implementation outcomes (acceptability, feasibility, and appropriateness) via open-ended survey. Nine school personnel (school-based mental health clinicians, nurses, administrators) completed lab-based usability testing of a dashboard tracking suicide risk of students, quantitative measures, and qualitative interviews to understand key implementation outcomes and determinants. School personnel were presented with a series of scenarios and common tasks focused on basic features and functions of the dashboard. Directed content analysis based on the Consolidated Framework for Implementation Research (CFIR) was used to extract multilevel determinants (i.e., the barriers or facilitators at the levels of the outer setting, inner setting, individuals, intervention, and implementation process) related to positive implementation outcomes for the TES.
Results:
Results:
Overarching themes related to implementation determinants and outcomes suggest that both student and school personnel users view TES for suicide prevention as moderately feasible and acceptable. Qualitative results suggest that students and school personnel view passive data collection based on social media data as a relative advantage to the current system; however, findings indicate that the TES and the school setting need to address issues
Conclusions:
Innovative suicide prevention strategies that rely on passive data collection in the school context are a promising and appealing idea. Usability testing identified key issues for revision to facilitate wide spread implementation.of privacy, integration into existing workflows and communication patterns, and options for individualization for student-centered care.
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Copyright
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