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Suicide Prevention Training for PC Providers-in-training

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ClinicalTrials.gov Identifier: NCT02996344
Recruitment Status : Active, not recruiting
First Posted : December 19, 2016
Last Update Posted : January 11, 2018
Sponsor:
Information provided by (Responsible Party):
Wendi Cross, University of Rochester

Brief Summary:
This randomized control study responds to the need for effective suicide prevention education/training that is grounded in adult learning theory and advances in education, in the context of a changing health care landscape where primary care providers are likely to encounter suicidal individuals. The study will test the effectiveness of suicide prevention education for providers-in-training by comparing two conditions: 1) A Control learning group: includes suicide prevention didactics (Commitment to Living: Primary Care) delivered online via brief videos, and 2) An Experimental learning group: includes didactics plus two standardized patient (SP) interactions. One Experimental learning group SP interaction will be in person and the other will be conducted remotely using a secure webcam service (OoVoo). All SP interactions will be recorded. Both groups will be compared in terms of their suicide prevention skills using an SP 'test case' at 6-month follow up. The primary research question is to learn about the impact of practice (though SP simulation) over and above didactics alone.

Condition or disease Intervention/treatment Phase
Suicide Prevention Other: Didactic training Other: Standardized patient interaction Not Applicable

Detailed Description:

Suicide is a national public health crisis and a critical patient safety issue. Suicide is the 10th leading cause of death overall and, shockingly, the 2nd leading cause of death in adolescents and young adults (15-34 years old). 1 A recent U.S. study of suicide reported that 45% of individuals who died by suicide had contact with primary care services within one month before their death. 2 Another study found that 80% of youth who died by suicide saw their primary care provider within the year of their death. 3 Patient safety is compromised when primary care providers lack the knowledge and skills to assess and respond to patients at risk for suicide.

This randomized control study responds to the need for effective suicide prevention education/training that is grounded in adult learning theory and advances in education, in the context of a changing health care landscape where primary care providers are likely to encounter suicidal individuals. 4 We will test the effectiveness of suicide prevention education for providers-in-training by comparing two conditions: 1) A Control learning group: includes suicide prevention didactics (Commitment to Living: Primary Care) delivered online via brief videos, and 2) An Experimental learning group: includes didactics plus two standardized patient (SP) interactions. One Experimental learning group SP interaction will be in person and the other will be conducted remotely using a secure webcam service (OoVoo). All SP interactions will be recorded. Both groups will be compared in terms of their suicide prevention skills using an SP 'test case' at 6-month follow up. The primary research question is to learn about the impact of practice (though SP simulation) over and above didactics alone. The hypotheses are as follows:

H1: All subjects will demonstrate improved suicide prevention knowledge from pre to post didactics and maintain improvement 6 months after didactics.

H2: Subjects in the experimental learning group will report greater satisfaction with the training, greater self-efficacy in identifying and responding to patients at risk for suicide, greater intention to use, as well as use of suicide prevention skills.

H3: Subjects in the experimental learning group will also be more skillful in responding to patients at risk for suicide (in an SP interview, measured by objective observed ratings) compared to the control learning group 6 months after didactics.

Exploratory Aims: We will examine moderators of outcomes, differences among SP simulations (i.e., face-to-face vs. telehealth modalities), and if there is growth in improved skills observed over multiple SP experiences in the experimental learning group.


Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 132 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Prevention
Official Title: Suicide Prevention Training for Primary Care Providers-in-training
Study Start Date : March 2016
Estimated Primary Completion Date : October 2018
Estimated Study Completion Date : October 2018

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Active Comparator: Didactic training
Behavioral; participants will view the approximately one hour Commitment to Living: Primary Care (CTL:PC) didactic training videos.
Other: Didactic training
Six online training modules pertaining to suicide prevention in primary care.

Experimental: Didactics and standardized patients
Behavioral; participants will view the approximately one hour Commitment to Living: Primary Care (CTL:PC) didactic training videos plus two practice standardized patient interactions.
Other: Didactic training
Six online training modules pertaining to suicide prevention in primary care.

Other: Standardized patient interaction
Two standardized patient practice interactions - 1 face-to-face, 1 remote/telehealth.




Primary Outcome Measures :
  1. Mean score using the Commitment to Living: Primary Care Observational Rating form [ Time Frame: through study completion, an average of 6 months ]
    Each participant will be evaluated via standardized patient interactions which are video taped and reliably coded using the Commitment to Living: Primary Care Observational Rating form. Score will range from 0 - 32.


Secondary Outcome Measures :
  1. Changes in suicide prevention knowledge [ Time Frame: 1 day following enrollment and 15 days from enrollment ]
    Participants will complete a 17-item knowledge questionnaire prior to and following the online didactic training. Number of correct responses will be compared.

  2. Changes in suicide prevention self-efficacy [ Time Frame: 1 day following enrollment and 15 days from enrollment ]
    Participants will complete a 20-item 5-point likert scale self-efficacy questionnaire prior to and following the online didactic training. Average responses will be compared.

  3. Changes in suicide prevention knowledge [ Time Frame: 15 days from enrollment and through study completion, an average of 6 months ]
    Participants will complete a 17-item knowledge questionnaire following the online didactic training and end of study. Number of correct responses will be compared.

  4. Number of participants intending to transfer training to practice [ Time Frame: 15 days from enrollment and through study completion, an average of 6 months ]
    Participants will complete a 8-item intentions to use training in practice on a 5-item likert scale questionnaire following the online didactic training and end of study. Number of participants who report positive intentions to use the training in practice will be compared.

  5. Changes in suicide prevention self-efficacy [ Time Frame: 15 days from enrollment and through study completion, an average of 6 months ]
    Participants will complete a 20-item 5-point likert scale self-efficacy questionnaire following the online didactic training and end of study. Average responses will be compared.

  6. Use of suicide prevention skills [ Time Frame: through study completion, an average of 6 months ]
    Participants will self-report whether they used suicide prevention skills in practice on 0-4 point likert scale, with 0 defined as no use and 4 as frequently used.

  7. Feedback on training [ Time Frame: through study completion, an average of 6 months ]
    Participants will provide feedback on their experience with suicide prevention training on 15 items using a 5-point likert scale.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • trainee in family medicine residency, pediatrics residency, or nurse practitioner program at URMC.
  • speaks/writes English.

Exclusion Criteria:

  • on academic probation

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02996344


Locations
United States, New York
University of Rochester Medical Center
Rochester, New York, United States, 14642
Sponsors and Collaborators
University of Rochester
Investigators
Principal Investigator: Wendi F Cross, PhD Associate Professor of Psychiatry (Psychology) and Pediatrics

Publications:
Responsible Party: Wendi Cross, Associate Professor, University of Rochester
ClinicalTrials.gov Identifier: NCT02996344     History of Changes
Other Study ID Numbers: 00061161
First Posted: December 19, 2016    Key Record Dates
Last Update Posted: January 11, 2018
Last Verified: January 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Additional relevant MeSH terms:
Suicide
Self-Injurious Behavior
Behavioral Symptoms