The study will determine whether community-based caring contact via a mobile app connection with or without volunteer support in addition to treatment as usual (psychiatric and psychosocial treatments) has an effect on suicidal ideation and treatment compliance among post-discharge self-harm young adults.
The proposed study will determine whether community-based caring contact via a mobile app connection with or without volunteer support in addition to treatment as usual (TAU; psychiatric and psychosocial treatments) is effective in reducing suicidal ideation, enhancing treatment compliance, reducing thwarted belongingness and perceived burdensomeness and hopelessness among post-discharge self-harm young adults, and if personalized contact by volunteers has additional effects reducing suicidal ideation among post-discharge self-harm individuals. 108 participants aged 18-45 with an index self-harm episode will be recruited from the Accident \& Emergency Department (AED) of 4 local public hospitals, and randomized into the TAU, mobile app group with, and without volunteer support. Each participant will complete a questionnaire at the 4 measurement time points at baseline (T0), one-month (T1) and the end of the 2-month intervention period (T2), and post-intervention at the three-month point (T3) from the baseline. The primary outcomes include Suicidal ideation, hopelessness, thwarted belongingness \& perceived burdensomeness, treatment (TAU) compliance, and suicidality.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
108
Each participant will be matched with a pair of trained volunteers (under pre-determined safety measures), who will initiate caring contact via telephone or text messages at least twice a month for two months. Participants will be free to respond or not.
Participants will receive programmed care messages and reminders of community resources and healthcare contacts on a regular basis. The app will also provide simple self-help mood checking and relaxation exercises.
Pamele Youde Nethersole Eastern Hospital
Chai Wan, Eastern District, Hong Kong
RECRUITINGUnited Christian Hospital
Sau Mau Ping, Kwun Tong District, Hong Kong
RECRUITINGNorth District Hospital
Sheung Shui, North District, Hong Kong
RECRUITINGChange from baseline Adult Suicidal Ideation at 1-month, 2-month and 3-month
Change in scores on Suicidal ideation as measured by the self-report the Adult Suicidal Ideation Questionnaire - the four-item short form in Chinese (ASIQ-4) (Fu, Liu, \& Yip, 2007)
Time frame: Baseline, 1 month, 2 months, 3 months
Change from baseline Measurement of Hopelessness at 1-month, 2-month and 3-month
Change in scores on Hopelessness as measured by a self-report 4-item short-form of Beck Hopelessness Scale Chinese version (BHS-4) (Beck, Weissman, Lester, \& Trexler, 1974; Yip \& Cheung, 2006; Shek, 1993).
Time frame: Baseline, 1 month, 2 months, 3 months
Change from baseline Interpersonal Needs at 1-month, 2-month and 3-month
Change in scores on Thwarted Belongingness (TB) and Perceived Burdensomeness (PB) as measured by the Interpersonal Needs Questionnaire (INQ-15), a 15-item measure of beliefs about whether one's need to belong is met or unmet and self-perceptions of being a burden to others (Van Orden, 2012).
Time frame: Baseline, 1 month, 2 months, 3 months
Change from baseline Service Utilization at 1-month, 2-month and 3-month
Self-reported compliance with prescribed treatment (frequency) in relation to the index self-harm episode, including psychiatric follow-up care (e.g., medication, out-patient follow-up treatment, and community psychiatric nursing service) and psycho-social services (e.g., clinical psychology service, medical social work service, etc.) as measured by a self-developed service utilization checklist.
Time frame: Baseline, 1 month, 2 months, 3 months
Change from baseline Suicidality at 1-month, 2-month and 3-month
Suicidality as measured by a four-item scale for levels of suicidality in the past 12 months (Centre for Suicide Research and Prevention, The University of Hong Kong, 2005)
Time frame: Baseline, 1 month, 2 months, 3 months
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Queen Mary Hospital
Central, Southern District, Hong Kong
RECRUITINGChange from baseline Depressive state at 1-month, 2-month and 3-month
Depressive state as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) (Lam et al., 2004).
Time frame: Baseline, 1 month, 2 months, 3 months
Change from baseline Self-harming repetition at 1-month, 2-month and 3-month
Self-reported frequency of self-harm repetition (retrieved from the Hong Kong Special Administrative Region (HKSAR) Coroner's Court)
Time frame: Baseline, 1 month, 2 months, 3 months
Change from baseline suicide deaths at 1-month, 2-month and 3-month
Number of suicide deaths (retrieved from the Hong Kong Special Administrative Region (HKSAR) Coroner's Court)
Time frame: Baseline, 1 month, 2 months, 3 months
Change of baseline index self-harm episode
Hospital records on the details of index self-harm episode including clinical diagnosis, treatment received, discharged information and number of Accident \& Emergency Department (AED) re-admissions, etc. in Clinical Management System (CMS), Outpatient Appointment System (OPAS), and Accident \& Emergency Department Clinical Information System (AEIS)
Time frame: Baseline, 1 month, 2 months, 3 months
Demographic and socioeconomic information
Questionnaire on participants' demographic and socioeconomic information (e.g. Sex, Date of birth, birth place, years living in Hong Kong, Marital status, religion, residential district, education, living status, employment, occupation, social security, etc.
Time frame: Baseline
Change of time spent on each programme activity of the app at 1-months, 2-months
The log-in time-stamp of each activity (including but not limited to reviewing the information or messages provided on the app, pattern of using the app, etc.)
Time frame: From Baseline to 2 months
Change of time spent and type of contact made by volunteers with participants at 1-months, 2-months
Volunteer service records on time-stamp of each type of contact (i.e. in-person, phone contact, letters \& email, and social media)
Time frame: 1-month, 2-months
Final and Monthly Qualitative Description on participants' progress
Reported by volunteers. items included case summary, services offered, volunteer-participant relationship, follow-up plan, self-reflection and areas of improvement, etc.
Time frame: up to 3 months