A Comparison of Two Brief Suicide Prevention Interventions Tailored for Youth on the Autism Spectrum

NCT ID: NCT05398250

Last Updated: 2025-01-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

1665 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-23

Study Completion Date

2026-09-30

Brief Summary

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Rates of suicide have increased significantly over the past two decades, particularly among youth. Compared to the general population, autistic people are significantly more likely to think about suicide, attempt suicide, and die by suicide. Autistic individuals have identified suicide prevention as a top research priority; however, little is known about how to best help autistic youth at risk for suicide. The purpose of this study is to compare the effectiveness, feasibility, and acceptability of two suicide prevention strategies tailored for autistic individuals: the Safety Planning Intervention tailored for Autistic individuals (SPI-A) and SPI-A plus structured follow-up contacts (SPI-A+).

Detailed Description

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This study includes three aims:

Aim 1: Among autistic youth (age 12-24) at risk for suicide, compare the effectiveness of SPI-A vs. SPI-A+. The primary outcomes of interest are suicidal ideation (SI) and suicidal behavior (SB). Secondary patient-centered outcomes are mental health treatment initiation and engagement, quality of life, well-being, skills to manage SI, access to lethal means, safety plan use, and acute care services for suicidality.

Aim 2: Compare implementation outcomes of acceptability and feasibility for the two interventions from the perspectives of patients, clinicians, and health system administrators.

Aim 3: Explore patient characteristics that may moderate the relationship between intervention and SI and SB.

Conditions

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Suicidal Ideation Suicidal and Self-injurious Behavior Suicide Autism Spectrum Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Safety Planning Intervention Tailored for Autistic Individuals

The Safety Planning Intervention Tailored for Autistic individuals (SPI-A) is a brief collaborative intervention that results in an individually tailored plan designed to lower the short-term risk of suicide in autistic youth.

Group Type ACTIVE_COMPARATOR

Safety Planning Intervention tailored for Autistic Individuals

Intervention Type BEHAVIORAL

To develop the SPI-A, clinicians work collaboratively with patients, and when indicated, their family members, to create a list of concrete coping mechanisms to be enacted leading up to or during a crisis. This list can be depicted in writing or pictorially, depending on patient preference. As part of the intervention, patients (and family members, when appropriate) also identify warning signs that signal the need to use the safety plan, as well as a detailed plan for reducing access to lethal means. SPI-A is a stand-alone intervention without a follow-up component.

Safety Planning Intervention Tailored for Autistic Individuals Plus Structured Follow-Up Contacts

The Safety Planning Intervention Tailored for Autistic individuals plus structured follow-up contacts (SPI-A+) is a multi-component intervention comprised of SPI-A and structured follow-up consisting of at least 2 brief contacts.

Group Type ACTIVE_COMPARATOR

Safety Planning Intervention Tailored for Autistic Individuals Plus Structured Follow-Up Contacts

Intervention Type BEHAVIORAL

SPI-A+ includes SPI-A plus a structured follow-up component. The structured follow-up component of SPI-A+ includes three elements:

1. A brief risk assessment and mood check
2. Review and, if needed, revision of SPI-A
3. Support related to outpatient mental health treatment initiation

Interventions

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Safety Planning Intervention tailored for Autistic Individuals

To develop the SPI-A, clinicians work collaboratively with patients, and when indicated, their family members, to create a list of concrete coping mechanisms to be enacted leading up to or during a crisis. This list can be depicted in writing or pictorially, depending on patient preference. As part of the intervention, patients (and family members, when appropriate) also identify warning signs that signal the need to use the safety plan, as well as a detailed plan for reducing access to lethal means. SPI-A is a stand-alone intervention without a follow-up component.

Intervention Type BEHAVIORAL

Safety Planning Intervention Tailored for Autistic Individuals Plus Structured Follow-Up Contacts

SPI-A+ includes SPI-A plus a structured follow-up component. The structured follow-up component of SPI-A+ includes three elements:

1. A brief risk assessment and mood check
2. Review and, if needed, revision of SPI-A
3. Support related to outpatient mental health treatment initiation

Intervention Type BEHAVIORAL

Other Intervention Names

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SPI-A SPI-A+

Eligibility Criteria

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Inclusion Criteria

* 12-24 years old
* Able and willing to provide informed consent (age ≥18) or assent and parental consent (age \<18)
* Able to speak English
* Have received a safety plan tailored for autistic youth during a clinical visit


* Employment as a provider serving autistic patients at one of the study sites
* Employment in a role that involves suicide risk intervention with youth patients at a participating clinic
* Able to read and speak English
* Able and willing to provide informed consent
* 18-99 years old


* Health system or clinic leader at one of the study sites
* Employed in a role that provides administrative oversight to clinicians conducting safety plans with patients
* Able to read and speak English
* Able and willing to provide informed consent
* 18-99 years old

Exclusion Criteria

* Altered mental status that precludes ability to provide informed assent or consent (acute psychosis, intoxication, or mania)

Clinician Participants



Health System Leader Participants
Minimum Eligible Age

12 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

University of Pennsylvania

OTHER

Sponsor Role collaborator

Nationwide Children's Hospital

OTHER

Sponsor Role collaborator

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

OTHER

Sponsor Role collaborator

Children's Hospital of Philadelphia

OTHER

Sponsor Role collaborator

Seattle Children's Hospital

OTHER

Sponsor Role collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Danielle Roubinov, PhD

Role: PRINCIPAL_INVESTIGATOR

University of North Carolina, Chapel Hill

Shari Jager-Hyman, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Locations

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Kennedy Krieger Institute

Baltimore, Maryland, United States

Site Status RECRUITING

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, United States

Site Status RECRUITING

Nationwide Children's Hospital

Columbus, Ohio, United States

Site Status RECRUITING

Children's Hospital of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Seattle Children's Hospital

Seattle, Washington, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Danielle Roubinov, PhD

Role: CONTACT

919-843-5898

Facility Contacts

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Paul Lipkin, MD

Role: primary

443-923-3240

Danielle Roubinov, PhD

Role: primary

919-843-5898

Eric Butter, PhD

Role: primary

614-722-4700

Amanda Bennett, MD

Role: primary

267-426-7540

Mendy Minjarez

Role: primary

206-987-8080

Other Identifiers

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21-2110

Identifier Type: -

Identifier Source: org_study_id

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