JMIR Publications

ABSTRACT

Background:

American Indian (AI) young adults in urban areas have many cultural strengths but also face unique challenges. Cultural norms within their communities strongly emphasize relationships. Previous research has found that receiving occasional positive and non-demanding messages – caring texts – can be beneficial among people experiencing depression and suicidality. To ameliorate increasing rates of suicide and suicidality among AI young adults, we implemented a Caring Text Message intervention designed to increase social connectedness to others.

Objective:

To assess the efficacy of a culturally tailored caring text messages intervention in reducing the burden of depressive symptoms and suicidal ideation among urban American Indian and Alaska Native young adults.

Methods:

This two-arm, double-blinded, randomized controlled trial is being implemented at two clinical sites with large AI populations. Partnering with clinics in Albuquerque, NM, and Rapid City, SD, we are recruiting AI adults ages 18-34 to participate in a Caring Text Message study. During the baseline study visit, participants complete surveys on suicidal ideation, suicide attempts and related hospitalizations, social connectedness, and other measures of mental health. Study staff interview participants to understand their history of suicidal behavior. After completion of the baseline visit, participants are randomized to receive the intervention—approximately 30 caring text messages—or treatment as usual. Participants are followed up at six- and 12-months post-baseline. At the final 12-month follow-up visit, they complete many of the same surveys and participate in an interview to ascertain suicidality in the time since their initial visit.

Results:

The New Mexico site has finished recruitment and is conducting follow-up assessments. The South Dakota site is still enrolling participants. The project has been well-received by participants.

Conclusions:

Culturally tailored caring text messages are well received. This trial will establish whether they are an effective strategy for reducing the burden of depressive symptoms and suicidal behaviors among AI young adults. Clinical Trial: ClinicalTrials.gov Identifier #NCT03136094