JMIR Publications

ABSTRACT

Background:

Suicide prevention is currently a national health priority in Canada. Emergency departments (EDs) are critical settings for suicide prevention and in our local psychiatric ED at the Centre for Addiction and Mental Health, we plan to embed an app-based tool, called the Hope app, to support suicide safety planning intervention. The app is free and available on app stores and usability tests have been completed. As a next step to embed this new tool into clinical routine flow, research is needed to assess determinants of implementation and design strategies for implementation, with an end goal of routinization.

Objective:

The purpose of this two-phased research is to implement the app into routine clinical flow in our local psychiatric ED. Specific objectives are as follows: 1) Understanding ED clinicians perceptions and experience of implementing the app into routine practice and identify barriers and facilitators to implementation (Phase 1); 2) Using findings and outputs from Phase 1, collaborate with services users, families and ED clinicians to co-design implementation strategies for the app (Phase 2).

Methods:

We will use an integrated knowledge translation (IKT) approach throughout this project. In Phase 1, we will conduct interviews with ED clinicians to identify implementation determinants using a behavior change framework. In Phase 2, a co-design team consisting of clinicians, ED service users, and families will design implementation strategies that align with the determinants identified in Phase 1.

Results:

The protocol presents detailed information about the entire structure of the two-phased research project. The ethics approval for conducting the qualitative descriptive study (Phase 1) is currently under review, and the recruitment and data collection processes will be completed no later than December 2023.

Conclusions:

Involving multiple knowledge user groups in the research and decision-making process early on is crucial for successful implementation. While co-designing is commonly practiced during innovation development, there is often a misconception that the responsibility for implementing what has been designed falls on others. This research aims to fill this methodological gap in the health informatics literature. By the end of this project, we will have developed theory-informed implementation strategies to support CAMH ED clinicians in adopting the Hope app to complete safety planning intervention. These strategies, guided by a behavior change framework, will target clinicians' behavior change and seamlessly integrate the app into routine clinical flow. Additionally, this research project will provide recommendations on how to involve multiple knowledge user groups and offer insights into how the methodology employed can be adapted to other areas within the health informatics literature. Clinical Trial: Not a clinical trial; N/A