JMIR Publications

ABSTRACT

Background:

: Self-help smartphone applications offer a new opportunity to address youth suicide prevention by improving access to support and by providing potentially high fidelity and cost-effective treatment. However, there have been very few smartphone apps providing evidence-based support for suicide prevention in this population. To address this gap, we developed the LifeBuoy app, a self-help smartphone app informed by dialectical behaviour therapy (DBT), to help young people manage suicidal thoughts in their daily life.

Objective:

This study describes the protocol of the randomized controlled trial to evaluate the efficacy of the LifeBuoy app for reducing suicidal thoughts and behaviours, depression, anxiety, and psychological distress, and improving general mental wellbeing in young adults aged 18-25 years.

Methods:

This is a randomised controlled, single-blind trial that compares the LifeBuoy app with a matched attention control (a placebo app with the same display but no DBT components). The primary outcome is suicidal thoughts measured by Suicidal Ideation Attributes Scale (SIDAS). Secondary outcomes include suicidal behaviours, depression, anxiety, psychological distress, and general mental wellbeing. The changes in the levels of insomnia, rumination, suicide cognitions, distress tolerance, loneliness, and help seeking before and after using the app are evaluated in this study. The study also addresses risk factors and response to the intervention. A series of items assessing COVID-19 experiences is included in the trial to capture the potential impact of the pandemic on this study. Assessments will occur on three occasions: baseline, post-intervention, and follow-up at three-month post-intervention. A qualitative interview about user experience with the LifeBuoy app will take place within four weeks of the final assessment. Using linear mixed models, the primary analysis will compare the changes in suicidal thoughts in the intervention condition relative to the control condition.

Results:

The trial recruitment started in May 2020. Data collection is currently ongoing.

Conclusions:

This is the first trial examining the efficacy of a DBT-informed smartphone application delivered to community-living young adults reporting suicidal thoughts. This trial will extend knowledge about the efficacy and acceptability of app-based support for suicidal thoughts in young people. Clinical Trial: Australian New Zealand Clinical Trials Registry (ACTRN12619001671156). Registered on 28 November 2019. Clinical Trial Notification (CTN) scheme (CT-2020-CTN-00256-1-v1). Registered on 24 February 2020.