Translating Suicide Safety Planning Components Into the Design of mHealth App Features: Systematic Review

BackgroundSuicide safety planning is an evidence-based approach used to help individuals identify strategies to keep themselves safe during a mental health crisis. This study systematically reviewed the literature focused on mobile health (mHealth) suicide safety planning app...

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Main Authors: Kim Gryglewicz, Victoria L Orr, Marissa J McNeil, Lindsay A Taliaferro, Serenea Hines, Taylor L Duffy, Pamela J Wisniewski
Format: Article
Language:English
Published: JMIR Publications 2024-03-01
Series:JMIR Mental Health
Online Access:https://mental.jmir.org/2024/1/e52763
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author Kim Gryglewicz
Victoria L Orr
Marissa J McNeil
Lindsay A Taliaferro
Serenea Hines
Taylor L Duffy
Pamela J Wisniewski
author_facet Kim Gryglewicz
Victoria L Orr
Marissa J McNeil
Lindsay A Taliaferro
Serenea Hines
Taylor L Duffy
Pamela J Wisniewski
author_sort Kim Gryglewicz
collection DOAJ
description BackgroundSuicide safety planning is an evidence-based approach used to help individuals identify strategies to keep themselves safe during a mental health crisis. This study systematically reviewed the literature focused on mobile health (mHealth) suicide safety planning apps. ObjectiveThis study aims to evaluate the extent to which apps integrated components of the safety planning intervention (SPI), and if so, how these safety planning components were integrated into the design-based features of the apps. MethodsFollowing the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we systematically analyzed 14 peer-reviewed studies specific to mHealth apps for suicide safety planning. We conducted an analysis of the literature to evaluate how the apps incorporated SPI components and examined similarities and differences among the apps by conducting a comparative analysis of app features. An independent review of SPI components and app features was conducted by downloading the available apps. ResultsMost of the mHealth apps (5/7, 71%) integrated SPI components and provided customizable features that expanded upon traditional paper-based safety planning processes. App design features were categorized into 5 themes, including interactive features, individualized user experiences, interface design, guidance and training, and privacy and sharing. All apps included access to community supports and revisable safety plans. Fewer mHealth apps (3/7, 43%) included interactive features, such as associating coping strategies with specific stressors. Most studies (10/14, 71%) examined the usability, feasibility, and acceptability of the safety planning mHealth apps. Usability findings were generally positive, as users often found these apps easy to use and visually appealing. In terms of feasibility, users preferred using mHealth apps during times of crisis, but the continuous use of the apps outside of crisis situations received less support. Few studies (4/14, 29%) examined the effectiveness of mHealth apps for suicide-related outcomes. Positive shifts in attitudes and desire to live, improved coping strategies, enhanced emotional stability, and a decrease in suicidal thoughts or self-harm behaviors were examined in these studies. ConclusionsOur study highlights the need for researchers, clinicians, and app designers to continue to work together to align evidence-based research on mHealth suicide safety planning apps with lessons learned for how to best deliver these technologies to end users. Our review brings to light mHealth suicide safety planning strategies needing further development and testing, such as lethal means guidance, collaborative safety planning, and the opportunity to embed more interactive features that leverage the advanced capabilities of technology to improve client outcomes as well as foster sustained user engagement beyond a crisis. Although preliminary evidence shows that these apps may help to mitigate suicide risk, clinical trials with larger sample sizes and more robust research designs are needed to validate their efficacy before the widespread adoption and use.
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spelling doaj.art-21d9815e8b164935b6aa861c7b8a37142024-03-28T14:00:53ZengJMIR PublicationsJMIR Mental Health2368-79592024-03-0111e5276310.2196/52763Translating Suicide Safety Planning Components Into the Design of mHealth App Features: Systematic ReviewKim Gryglewiczhttps://orcid.org/0000-0003-4395-2354Victoria L Orrhttps://orcid.org/0009-0009-6556-2577Marissa J McNeilhttps://orcid.org/0000-0001-8881-1649Lindsay A Taliaferrohttps://orcid.org/0000-0003-2856-0897Serenea Hineshttps://orcid.org/0000-0002-7085-9190Taylor L Duffyhttps://orcid.org/0000-0002-2372-7507Pamela J Wisniewskihttps://orcid.org/0000-0002-6223-1029 BackgroundSuicide safety planning is an evidence-based approach used to help individuals identify strategies to keep themselves safe during a mental health crisis. This study systematically reviewed the literature focused on mobile health (mHealth) suicide safety planning apps. ObjectiveThis study aims to evaluate the extent to which apps integrated components of the safety planning intervention (SPI), and if so, how these safety planning components were integrated into the design-based features of the apps. MethodsFollowing the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we systematically analyzed 14 peer-reviewed studies specific to mHealth apps for suicide safety planning. We conducted an analysis of the literature to evaluate how the apps incorporated SPI components and examined similarities and differences among the apps by conducting a comparative analysis of app features. An independent review of SPI components and app features was conducted by downloading the available apps. ResultsMost of the mHealth apps (5/7, 71%) integrated SPI components and provided customizable features that expanded upon traditional paper-based safety planning processes. App design features were categorized into 5 themes, including interactive features, individualized user experiences, interface design, guidance and training, and privacy and sharing. All apps included access to community supports and revisable safety plans. Fewer mHealth apps (3/7, 43%) included interactive features, such as associating coping strategies with specific stressors. Most studies (10/14, 71%) examined the usability, feasibility, and acceptability of the safety planning mHealth apps. Usability findings were generally positive, as users often found these apps easy to use and visually appealing. In terms of feasibility, users preferred using mHealth apps during times of crisis, but the continuous use of the apps outside of crisis situations received less support. Few studies (4/14, 29%) examined the effectiveness of mHealth apps for suicide-related outcomes. Positive shifts in attitudes and desire to live, improved coping strategies, enhanced emotional stability, and a decrease in suicidal thoughts or self-harm behaviors were examined in these studies. ConclusionsOur study highlights the need for researchers, clinicians, and app designers to continue to work together to align evidence-based research on mHealth suicide safety planning apps with lessons learned for how to best deliver these technologies to end users. Our review brings to light mHealth suicide safety planning strategies needing further development and testing, such as lethal means guidance, collaborative safety planning, and the opportunity to embed more interactive features that leverage the advanced capabilities of technology to improve client outcomes as well as foster sustained user engagement beyond a crisis. Although preliminary evidence shows that these apps may help to mitigate suicide risk, clinical trials with larger sample sizes and more robust research designs are needed to validate their efficacy before the widespread adoption and use.https://mental.jmir.org/2024/1/e52763
spellingShingle Kim Gryglewicz
Victoria L Orr
Marissa J McNeil
Lindsay A Taliaferro
Serenea Hines
Taylor L Duffy
Pamela J Wisniewski
Translating Suicide Safety Planning Components Into the Design of mHealth App Features: Systematic Review
JMIR Mental Health
title Translating Suicide Safety Planning Components Into the Design of mHealth App Features: Systematic Review
title_full Translating Suicide Safety Planning Components Into the Design of mHealth App Features: Systematic Review
title_fullStr Translating Suicide Safety Planning Components Into the Design of mHealth App Features: Systematic Review
title_full_unstemmed Translating Suicide Safety Planning Components Into the Design of mHealth App Features: Systematic Review
title_short Translating Suicide Safety Planning Components Into the Design of mHealth App Features: Systematic Review
title_sort translating suicide safety planning components into the design of mhealth app features systematic review
url https://mental.jmir.org/2024/1/e52763
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