Accepted for/Published in: JMIR Formative Research
Date Submitted: Sep 14, 2020
Date Accepted: Mar 15, 2021
Brief Interventions via Electronic Health Record Messaging for Population-Based Suicide Prevention: A Pilot Study
ABSTRACT
Background:
New opportunities to create and evaluate population-based selective prevention programs for suicidal behavior are emerging in healthcare settings. Standard depression severity measures recorded in electronic medical records (EMR) can be used to identify patients at risk for suicidal behavior and promising interventions for reducing risk of suicide attempt in at-risk populations can be adapted for web-based delivery in healthcare.
Objective:
To evaluate a pilot of a psychoeducational program involving elements of caring messages, focused on developing emotion regulation techniques via a web-based dialectical behavioral therapy (DBT) skills platform, and supported by a secure-message coaching.
Methods:
Patients were eligible based EMR documented PHQ depression questionnaire responses indicating suicidal thoughts. We measured feasibility (via proportion opening program invitations), acceptability (via program feedback), and engagement (via proportion began DBT skills, DBT skill site visits and degree of site engagement).
Results:
Sixty patients were invited to participate. Fifty-six (93%) opened the invitation and 26 (43%) consented to participation. DBT skill site utilizers logged in a mean of 5.3 times. Procedures resulted in no complaints and some participant feedback.
Conclusions:
This study supports the potential of using responses to PHQ depression questionnaires in the EMR to identify a high-risk population and offer key elements of caring messages and DBT adapted for a low-intensity intervention. A randomized trial evaluating the effectiveness of this program is now underway (ClinicalTrials.gov: NCT02326883). Intervention content for the program evaluated here is available at NowMattersNow.org.
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