The goal of this research project is to conduct a pilot RCT of Text4Strength, an interactive automated text messaging extension of Sources of Strength (SoS), a universal school-based suicide prevention program that prepares diverse 'key opinion leaders' to conduct public health messaging and activities with peers to increase school-wide positive coping norms, communication with trusted adults, and seeking help for suicidal peers (Wyman et al., 2010). The investigators previously developed and field tested Text4Strength messages (RSRB#00047481 and 53924 closed) to demonstrate feasibility, safety, student engagement, and student-perceived relevance for a universal texting extension. The investigators will now conduct a pilot randomized controlled trial in one large school in Western New York that has implemented Sources of Strength for the past two years. The school will continue with Sources of Strength in the 2016-17 school, and add this school-wide texting component as part of this research study. Consistent with Leon's guidelines on pilot studies, the primary focus will be to identify areas of promise, success in reaching proximate targets, and the need for additional modifications (Leon, Davis, \& Kraemer, 2011). Findings from this study will inform further refinement of the text messaging program and provide preliminary data for a larger efficacy trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
222
The intervention group will receive 2-5 interactive text message sequences per week. These messages will invite students to reply using keywords and short free text replies. Messages come from a library of strength-based peer quotations (reviewed for safety), psychoeducational interactions, and games designed to promote emotional skills and use of resources.
The control group will receive 1-2 (non-interactive) text messages per week containing general SoS concepts (e.g., "Remember: more strengths are better when times get tough").
Emotion self-regulation skills
Difficulties with Emotion Regulation Scales (DERS) (Gratz \& Roemer, 2004)
Time frame: change from baseline to three-month follow-up
Resources for Coping
uptake of Sources of Strength concepts (Wyman et al., 2010)
Time frame: change from baseline to three-month follow-up
Help-Seeking norms
Help-seeking from adults at school (Schmeelk-Cone, et al, 2012)
Time frame: change from baseline to three-month follow-up
Depression
Mood and Feelings Questionnaire (MFQ: Angold, et al., 1996; Costello \& Angold, 1988)
Time frame: baseline, immediate follow-up, three-month follow-up
Suicidal Ideation
one question from the MFQ about suicidal ideation in the past two weeks
Time frame: baseline, immediate follow-up, three-month follow-up
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