Suicide Prevention Training for PC Providers-in-training

NCT ID: NCT02996344

Last Updated: 2020-02-12

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 132 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-03-15
• Study Completion Date: 2018-06-07

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.

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.

Conditions

Suicide Prevention

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: SINGLE

Study Groups

Didactic training

Behavioral; participants will view the approximately one hour Commitment to Living: Primary Care (CTL:PC) didactic training videos.

Group Type: ACTIVE_COMPARATOR

Didactic training

Intervention Type: OTHER

Six online training modules pertaining to suicide prevention in primary care.

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.

Group Type: EXPERIMENTAL

Didactic training

Intervention Type: OTHER

Six online training modules pertaining to suicide prevention in primary care.

Standardized patient interaction

Intervention Type: OTHER

Two standardized patient practice interactions - 1 face-to-face, 1 remote/telehealth.

Interventions

Didactic training

Six online training modules pertaining to suicide prevention in primary care.

Intervention Type: OTHER

Standardized patient interaction

Two standardized patient practice interactions - 1 face-to-face, 1 remote/telehealth.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

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

Exclusion Criteria

• on academic probation

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Rochester

OTHER

Sponsor Role: lead

Responsible Party

Wendi Cross

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Wendi F Cross, PhD

Role: PRINCIPAL_INVESTIGATOR

Associate Professor of Psychiatry (Psychology) and Pediatrics

Locations

University of Rochester Medical Center

Rochester, New York, United States

Countries

United States

References

Ahmedani BK, Simon GE, Stewart C, Beck A, Waitzfelder BE, Rossom R, Lynch F, Owen-Smith A, Hunkeler EM, Whiteside U, Operskalski BH, Coffey MJ, Solberg LI. Health care contacts in the year before suicide death. J Gen Intern Med. 2014 Jun;29(6):870-7. doi: 10.1007/s11606-014-2767-3. Epub 2014 Feb 25.

Reference Type: BACKGROUND

PMID: 24567199 (View on PubMed)

Bridge JA, Horowitz LM, Fontanella CA, Grupp-Phelan J, Campo JV. Prioritizing research to reduce youth suicide and suicidal behavior. Am J Prev Med. 2014 Sep;47(3 Suppl 2):S229-34. doi: 10.1016/j.amepre.2014.06.001.

Reference Type: BACKGROUND

PMID: 25145744 (View on PubMed)

Wyzga RE. The effect of air pollution upon mortality: a consideration of distributed lag models. J Am Stat Assoc. 1978;73(363):463-72. doi: 10.1080/01621459.1978.10480035. No abstract available.

Reference Type: BACKGROUND

PMID: 12262745 (View on PubMed)

Pisani AR, Cross WF, Watts A, Conner K. Evaluation of the Commitment to Living (CTL) curriculum: a 3-hour training for mental health professionals to address suicide risk. Crisis. 2012 Jan 1;33(1):30-8. doi: 10.1027/0227-5910/a000099.

Reference Type: BACKGROUND

PMID: 21940243 (View on PubMed)

Aiken LS, West SG. Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage; 1991.

Reference Type: BACKGROUND

Cross WF, West JC, Pisani AR, Crean HF, Nielsen JL, Kay AH, Caine ED. A randomized controlled trial of suicide prevention training for primary care providers: a study protocol. BMC Med Educ. 2019 Feb 14;19(1):58. doi: 10.1186/s12909-019-1482-5.

Reference Type: DERIVED

PMID: 30764814 (View on PubMed)

Other Identifiers

00061161

Identifier Type: -

Identifier Source: org_study_id