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Stepped Approach to Reducing Risk of Suicide in Primary Care
Sponsor: Cynthia Fontanella
Summary
Suicide is the second leading cause of death among young people aged 12-17 years in the United States, yet many youth at risk for suicide are not identified or go untreated. Stepped care approaches have been shown to be effective at reducing suicide risk in clinical settings, including primary care. The goal of this hybrid I stepped wedge effectiveness-implementation study is to test the effectiveness of a population-based quality improvement (QI) intervention, entitled STARRS-PC (Stepped Approach to Reducing Risk of Suicide in Primary Care) compared to treatment as usual (TAU), in reducing the risk of suicidal behavior among youth in the pediatric primary care setting. STARRS-PC implements a clinical pathway for youth at elevated risk for suicide in pediatric primary care clinics. Clinical pathways are tools used by health professionals to guide evidence-informed practice. The STARRS-PC pathway consists of three evidence-based suicide clinical care processes: risk detection, assessment and triage, and, if needed, follow-up transitional care. STARRS-PC is guided by the Practical, Robust Implementation, and Sustainability Model (PRISM), which allows for the study of factors that influence effective implementation of the suicide prevention clinical pathway and is focused on scalability. The main questions the study aims to answer are: * Will STARRS-PC be more effective than TAU at reducing the rate of suicide attempt at 12 months post-baseline (primary outcome)? * Will STARRS-PC be more effective than TAU at reducing suicidal ideation and non-suicidal self-injury, and improving family satisfaction at 12 months post-baseline (secondary outcomes)? * What are the barriers and facilitators of effective implementation and sustainability of STARRS-PC?
Key Details
Gender
All
Age Range
12 Years - 17 Years
Study Type
INTERVENTIONAL
Enrollment
2572
Start Date
2023-08-08
Completion Date
2027-07-31
Last Updated
2025-08-08
Healthy Volunteers
No
Interventions
Stepped Approach to Reducing Risk of Suicide in Primary Care
Intervention consists of implementation of clinical pathway for youth suicide risk
Locations (15)
AxessPointe Community Health Centers/Health Quarters
Akron, Ohio, United States
Signature Health
Ashtabula, Ohio, United States
Holzer Health System
Athens, Ohio, United States
Nationwide Children's Hospital
Columbus, Ohio, United States
Dayton Children's Hospital - Hope Center
Dayton, Ohio, United States
Dayton Children's Hospital - Main
Dayton, Ohio, United States
Holzer Health System
Gallipolis, Ohio, United States
Hilliard Pediatrics
Hilliard, Ohio, United States
Holzer Health System
Jackson, Ohio, United States
Maumee Pediatric Associates
Maumee, Ohio, United States
Cornerstone Pediatrics
Miamisburg, Ohio, United States
Signature Health
Painesville, Ohio, United States
Village Square Primary Care Center
Perrysburg, Ohio, United States
Franklin Avenue Primary Care Center
Toledo, Ohio, United States
Signature Health
Willoughby, Ohio, United States