JMIR Publications

ABSTRACT

Background:

Suicide is the third leading cause of death among Black adults ages 18-35. Although men compose a majority of suicide deaths among Black adults, less is known regarding the extent to which unique cultural stressors, such as racism-related stress (e.g., racial discrimination), are salient in exacerbating suicide risk among Black men. Moreover, few studies examine the daily influence of racism-related stressors on suicide outcomes using real-time smartphone-based approaches. Smartphone-based mobile health approaches using ecological momentary assessments (EMA) provide an opportunity to assess and characterize racism-related stressors as a culturally sensitive suicide risk factor among Black young adult men.

Objective:

The goal of the current study is to describe a protocol development process that aims to capture real-time racism-related stressors and suicide outcomes using a smartphone-based EMA platform (Metricwire).

Methods:

Guided by the Interpersonal Theory of Suicide (ITS), we developed a brief EMA protocol using a multi-phased approach. First, we conducted a literature review to identify measures previously used in EMA studies, with special emphasis on studies including Black participants. Identified measures were then shortened to items with the highest construct validity (e.g., factor loadings) and revised to reflect momentary or daily frequency. Feasibility and acceptability of the study protocol will be assessed using self-report survey and qualitative responses. To protect participants from harm, a two-tier safety protocol was developed to identify participants with moderate and acute risk based on EMA survey response in order to trigger outreach by the study coordinator.

Results:

The final EMA protocol, which will be completed over a 7-day period, is comprised of 15 questions administered 4x/day and 22 questions related to sleep impairment and disruption, as well as racism-related stress, to be delivered at the end of each day. Study recruitment is currently underway. The anticipated date for completion for the study will be February 2023. Dissemination will be conducted through peer reviewed publications and conference presentations.

Conclusions:

This protocol will address gaps in our understanding of Black men’s suicide outcomes in the social contexts that they regularly navigate and clarifies the temporal role of racism-related stressors that influence suicidal outcomes.