We present results from a 2-site, randomized clinical trial to assess the efficacy of a brief intervention (As Safe As Possible [ASAP]), a safety plan phone application (BRITE), and their combination on suicide attempts, suicidal ideation, non-suicidal self-injury, re-hospitalizations. and suicidal events among adolescents. Adolescents (n= 240; 12-17 years of age) who were hospitalized for suicidal ideation with plan and/or intent, and/or suicide attempt, were assigned to 1 of 4 treatment conditions in a 2 by 2 design: ASAP+BRITE app+treatment as usual (TAU); (2) BRITE+TAU; (3) ASAP+TAU; and (4) TAU alone. Independent evaluators assessed suicidal ideation and behavior at 4, 12, and 24 weeks using the Columbia–Suicide Severity Rating Scale (C-SSRS) and re-hospitalization using the Child and Adolescent Services Assessment (CASA). No group differences were found on primary outcomes, except that ASAP participants were less likely to be re-hospitalized over 6 months (15.6%, vs 26.5%, = .046). Participants hospitalized for an attempt and assigned to BRITE had a lower rate of subsequent attempts (odds ratio [OR] = 0.16, = .01) and a greater time to attempt (hazard ratio [HR] = 0.20, = .02). ASAP+BRITE, albeit not statistically significant, was most consistently associated with a reduction (60% reduction) in suicide attempts. ASAP, BRITE, and their combination are equally effective at decreasing risk for suicidal events 6 months post hospital discharge among suicidal adolescents; the ASAP intervention (with or without BRITE) was associated with lower rates of re-hospitalization. The BRITE app in youth hospitalized for suicide attempt had promising outcomes in regard to future attempts. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. The research was performed with permission from the University of Pittsburgh Institutional Review Board and the University of Texas Institutional Review Board. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. Establishing Efficacy of an Inpatient Intervention and Phone App to Reduce Suicidal Risk (ASAP+BRITE); ;

中文翻译：

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弥补自杀青少年住院后的护理差距：尽可能安全 (ASAP) 和 BRITE 应用程序


我们展示了一项 2 点随机临床试验的结果，以评估简短干预（尽可能安全 [ASAP]）、安全计划电话应用程序 (BRITE) 及其组合对自杀未遂、自杀意念、非自杀行为的有效性。 -自杀自伤、再次住院。以及青少年自杀事件。因计划和/或意图自杀和/或自杀企图而住院的青少年（n = 240；12-17 岁）被分配到 2 x 2 设计中 4 种治疗条件中的一种：ASAP+BRITE照常应用程序+治疗 (TAU)； (2)BRITE+TAU； (3) 尽快+TAU； (4)单独的TAU。独立评估人员使用哥伦比亚自杀严重程度评定量表 (C-SSRS) 评估第 4、12 和 24 周时的自杀意念和行为，并使用儿童和青少年服务评估 (CASA) 评估再住院情况。主要结局没有发现组间差异，除了 ASAP 参与者在 6 个月内再次住院的可能性较小（15.6% vs 26.5%，= 0.046）。因尝试而住院并分配至 BRITE 的参与者后续尝试率较低（比值比 [OR] = 0.16，= .01），尝试时间较长（风险比 [HR] = 0.20，= .02）。 ASAP+BRITE 尽管在统计上不显着，但与自杀企图减少（减少 60%）最一致。 ASAP、BRITE 及其组合对于降低有自杀倾向的青少年出院后 6 个月的自杀事件风险同样有效； ASAP 干预（有或没有 BRITE）与较低的再住院率相关。 BRITE 应用程序对因自杀未遂而住院的青少年来说，在未来的自杀尝试方面取得了可喜的成果。我们努力确保招募人类参与者时的性别和性别平衡。 我们努力确保招募人类参与者时的种族、民族和/或其他类型的多样性。我们努力确保研究问卷的准备具有包容性。该研究是在匹兹堡大学机构审查委员会和德克萨斯大学机构审查委员会的许可下进行的。本文的一位或多位作者自我认同为一个或多个历史上在科学领域代表性不足的种族和/或族裔群体的成员。本文的一位或多位作者自我认同为科学界一个或多个历史上代表性不足的性和/或性别群体的成员。本文的一位或多位作者得到了一项旨在提高少数群体在科学领域代表性的计划的支持。我们积极致力于促进作者群体中的性和性别平衡。我们积极致力于促进将历史上代表性不足的种族和/或族裔群体纳入我们的作者群体中。本文的作者名单包括来自研究进行地点和/或社区的贡献者，他们参与了工作的数据收集、设计、分析和/或解释。确定住院干预和电话应用程序降低自杀风险的功效（ASAP+BRITE）； ;