BRITEPath- Phase 2

University of Pittsburgh

Status: Completed

Conditions: Suicidal Ideation; Depression

Treatments: Behavioral: Treatment As Usual (TAU); Behavioral: BRITEPath

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04672798

STUDY20110359

P50MH115838-02 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

BRITEPath (BP) aims to support co-located mental health clinicians in the development of a high quality, effective, and personalized safety plan for referred patients who screen positive for depression and/or suicidal ideation.

BRITEPath utilizes BRITE, a safety planning and emotion regulation app that is loaded on the patient's smart phone and has previously been shown to be well accepted and to reduce suicide attempts compared to usual care in psychiatric inpatients (HR = 0.49). To support mental health clinicians in the development of effective safety plans, study investigators will develop Guide2Brite (G2B), which provides step-by-step instructions for the mental health clinician on how to populate BRITE onto the patient's smartphone and BRITEBoard, a clinician dashboard that tracks patient symptoms, app use, and rating on helpfulness of different interventions assessed through BRITE.

Full description

BRITEPath has 3 components: 1) BRITE, an emotion regulation and safety planning phone app that is delivered by a co-located mental health (MH) clinician to adolescents at the time of their first therapy appointment; 2) Guide2Brite, which will guide the co-located MH clinician in working with the adolescent to population content onto BRITE; and 3) BRITEBoard, which is a clinician dashboard delivered to the MH clinician and PCP.

Assignment of Interventions: This study will utilize a 1:1 randomization scheme to randomize participants to receive BRITEPath intervention or Treatment as Usual (TAU).

Hypothesis: The use of BRITEPath will decrease depressive symptoms, distress, and suicidality (any self-injurious ideation, urges, or behavior) as well as improve overall functioning compared to TAU.

Enrollment: 101 patients

Sex: All

Ages: 12 to 26 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Youth aged 12-26yo
2. Own a device (e.g. smartphone, iPod, tablet) with capability to download BRITE app
3. Biological or adoptive parent is willing to provide informed consent for teen to participate
4. Youth speaks and understands English
5. Positive PHQ score or provider determines youth has depressive symptoms based on clinical interaction and refers youth to the study (in cases when PHQ is not available and study staff will complete the PHQ during the screening) OR Provider can refer if they are unclear if symptoms are depressive and PHQ scoring will be used to determine youth's eligibility. OR Screening Wizard screening questionnaire (which includes the PHQ and depressive symptom questions) indicates depression OR provider/parent have concern that youth/patient has a mood or behavioral problem
6. Family agrees to see an (embedded) MH therapist at the practice
7. PHQ scores: Score of 8 or higher on PHQ-8 -or- Score of 1 or higher on #9 of PHQ-9 suicidality item

Exclusion criteria

1. Non English speaking
2. No parent willing to provide informed consent
3. No cell phone capability of downloading BRITE app
4. Is currently experiencing mania or psychosis
5. Evidence of an intellectual or developmental disorder (IDD)
6. Life threatening medical condition that requires immediate treatment (including emergent suicidality, homicidally, abuse/neglect, or other mental or physical condition)
7. Other cognitive or medical condition preventing youth from understanding study and/or participating.
8. Currently receiving MH treatment/currently satisfied with treatment

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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101 participants in 2 patient groups

BRITEPath

Experimental group

Description:

Participants will receive the components in BRITEPath from a mental health (MH) clinical trained by the study staff/PI's on how to implement BRITE safety planning with fidelity. First, the MH clinician will review possible barriers to implementation of the safety plan and problem-solve appropriately with patient and parent(s); (2) BRITE is the emotion regulation/safety planning app loaded on the patient's smartphone that populated with support from Guide2BRITE; and (3) BRITEBoard, a clinician dashboard that shows app use, change in distress and symptoms ratings, and can be used for shared decision making with parents, patients, and PCPs. Clinicians will review adolescent's skill development and app content with parents. Prior to discharge or following acute increases in suicide risk.

Treatment:

Behavioral: BRITEPath

Treatment As Usual (TAU)

Active Comparator group

Description:

Participants in the TAU group will receive treatment from their mental health clinician which may include safety planning.

Treatment:

Behavioral: Treatment As Usual (TAU)