有自杀风险的现役军人危机应对计划与常规治疗的比较:在军事治疗设施中进行的阶梯形随机试验的研究方案。

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Contemporary Clinical Trials Communications Pub Date : 2024-12-01 DOI:10.1016/j.conctc.2024.101407
Kristen H. Walter , Pia R. Khandekar , Alexander C. Kline , Erin L. Miggantz , Nicholas P. Otis , Lisa H. Glassman , Cynthia J. Thomsen , Guy Brock , Craig J. Bryan
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引用次数: 0

摘要

背景:自杀是美国军人死亡的主要原因之一,在过去的二十年里,军人的自杀率有所上升。为了解决这一严重问题,需要在经常见到有危险的服务人员的环境中,如急诊科和精神病住院病房,采取有效的预防性治疗。本研究将比较危机应对计划(CRP)和常规治疗(TAU)对在军事治疗机构寻求自杀紧急护理的现役军人自杀念头和行为的纵向影响。方法:目前的研究是通过一个联盟进行的,为服务成员增加自杀预防干预。这篇文章详细介绍了一项正在进行的楔形聚类随机临床试验,该试验比较了在接受过crp培训的提供者和未接受过培训的提供者(即TAU)的护理后,有自杀风险的服务人员的自杀念头和行为比率。参与者在预处理时和每3个月完成一次评估,直至1年。主要结果包括自杀企图和行为,自杀意念是次要结果。还将研究治疗效果的调节因子。讨论了该试验的方法学发展,以及在急诊、住院和军事治疗环境中自杀预防研究的临床和伦理考虑。结论:针对服务人员的独特需求提供基于证据的自杀治疗对于降低自杀率和促进这一人群的心理健康恢复至关重要。本研究旨在为今后在医疗保健系统中实施和传播CRP提供信息,以最终降低服务人员的自杀率。临床试验标识符:NCT05795764。
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Comparison of crisis response planning and treatment as usual for active duty service members at risk for suicide: Study protocol for a stepped-wedge cluster randomized trial in a military treatment facility

Background

Suicide is one of the leading causes of death among U.S. service members, and rates of suicide among military personnel have increased over the past two decades. To address this serious issue, effective preventive treatments are needed in settings where at-risk service members are frequently seen, such as emergency departments and inpatient psychiatric units. This study will compare the longitudinal effects of crisis response planning (CRP) and treatment as usual (TAU) on suicidal thoughts and behaviors among active duty service members seeking emergent care for suicidality at a military treatment facility.

Methods

The current study is conducted through a consortium, Augmenting Suicide Prevention Interventions for Service Members. This article details an ongoing stepped-wedge cluster randomized clinical trial that compares rates of suicidal thoughts and behaviors among service members at risk for suicide following care from CRP-trained providers versus untrained providers (i.e., TAU). Participants complete assessments at pretreatment and every 3 months up to 1 year. Primary outcomes include suicide attempts and behaviors, and suicidal ideation is a secondary outcome. Moderators of treatment effects will also be examined. The methodological development of this trial is discussed, along with clinical and ethical considerations for suicide prevention research in emergency, inpatient, and military treatment settings.

Conclusion

Providing evidence-based treatment for suicidality that addresses service members’ unique needs is crucial to reduce suicide rates and facilitate mental health recovery in this population. This study aims to inform future implementation and dissemination of CRP in healthcare systems to ultimately decrease suicide among service members.

Clinical trials identifier

NCT05795764.
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来源期刊
Contemporary Clinical Trials Communications
Contemporary Clinical Trials Communications Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
2.70
自引率
6.70%
发文量
146
审稿时长
20 weeks
期刊介绍: Contemporary Clinical Trials Communications is an international peer reviewed open access journal that publishes articles pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from a wide range of disciplines including medicine, life science, pharmaceutical science, biostatistics, epidemiology, computer science, management science, behavioral science, and bioethics. Contemporary Clinical Trials Communications is unique in that it is outside the confines of disease specifications, and it strives to increase the transparency of medical research and reduce publication bias by publishing scientifically valid original research findings irrespective of their perceived importance, significance or impact. Both randomized and non-randomized trials are within the scope of the Journal. Some common topics include trial design rationale and methods, operational methodologies and challenges, and positive and negative trial results. In addition to original research, the Journal also welcomes other types of communications including, but are not limited to, methodology reviews, perspectives and discussions. Through timely dissemination of advances in clinical trials, the goal of Contemporary Clinical Trials Communications is to serve as a platform to enhance the communication and collaboration within the global clinical trials community that ultimately advances this field of research for the benefit of patients.
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