Leveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment: a pilot study protocol
Abstract Background Primary care is an ideal setting to connect individuals at risk for suicide to follow-up care; however, only half of the patients referred from the primary care attend an initial mental health visit. We aim to develop acceptable, feasible, low-cost, and effective new strategies t...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | Pilot and Feasibility Studies |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40814-022-01131-y |
| _version_ | 1811215869412376576 |
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| author | Gabriela Kattan Khazanov Shari Jager-Hyman Joseph Harrison Molly Candon Alison Buttenheim Matteo F. Pieri David W. Oslin Courtney Benjamin Wolk |
| author_facet | Gabriela Kattan Khazanov Shari Jager-Hyman Joseph Harrison Molly Candon Alison Buttenheim Matteo F. Pieri David W. Oslin Courtney Benjamin Wolk |
| author_sort | Gabriela Kattan Khazanov |
| collection | DOAJ |
| description | Abstract Background Primary care is an ideal setting to connect individuals at risk for suicide to follow-up care; however, only half of the patients referred from the primary care attend an initial mental health visit. We aim to develop acceptable, feasible, low-cost, and effective new strategies to increase treatment initiation among at-risk individuals identified in primary care. Methods We will conduct a multi-phase, mixed-methods study. First, we will conduct a chart review study by using administrative data, including medical records, to identify characteristics of primary care patients at risk for suicide who do or do not attend an initial mental health visit following a referral. Second, we will conduct a mixed methods study by using direct observations and qualitative interviews with key stakeholders (N = 65) to understand barriers and facilitators to mental health service initiation among at-risk individuals. Stakeholders will include patients with suicidal ideation referred from primary care who do and do not attend a first mental health visit, primary care and behavioral health providers, and individuals involved in the referral process. We also will collect preliminary self-report and behavioral data regarding potential mechanisms of behavior change (i.e., self-regulation and social support) from patients. Third, we will leverage these findings, relevant frameworks, and the extant literature to conduct a multi-arm, non-randomized feasibility trial. During this trial, we will rapidly prototype and test strategies to support attendance at initial mental health visits. Strategies will be developed with subject matter experts (N = 10) and iteratively pilot tested (~5 patients per strategy) and refined. Research will be completed in the Penn Integrated Care Program (PIC), which includes fourteen primary care clinics in Philadelphia that provide infrastructure for electronic referrals, patient communication, and data access. Discussion We will leverage frameworks and methods from behavioral economics and implementation science to develop strategies to increase mental health treatment initiation among individuals at risk for suicide identified in primary care. This project will lead to an evaluation of these strategies in a fully powered randomized trial and contribute to improvements in access to and engagement in mental health services for individuals at risk for suicide. Trial registration ClinicalTrials.gov Identifier: NCT05021224 |
| first_indexed | 2024-04-12T06:30:48Z |
| format | Article |
| id | doaj.art-e2d7827faa6a4a6d9298d072bdc1b5f1 |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-04-12T06:30:48Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-e2d7827faa6a4a6d9298d072bdc1b5f12022-12-22T03:44:02ZengBMCPilot and Feasibility Studies2055-57842022-08-018111210.1186/s40814-022-01131-yLeveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment: a pilot study protocolGabriela Kattan Khazanov0Shari Jager-Hyman1Joseph Harrison2Molly Candon3Alison Buttenheim4Matteo F. Pieri5David W. Oslin6Courtney Benjamin Wolk7Mental Illness Research, Education, and Clinical Center of the Veterans Integrated Service Network 4, Crescenz Veterans Affairs Medical CenterLeonard Davis Institute of Health Economics, University of PennsylvaniaCenter for Health Incentives and Behavioral Economics, University of Pennsylvania School of MedicineLeonard Davis Institute of Health Economics, University of PennsylvaniaLeonard Davis Institute of Health Economics, University of PennsylvaniaDepartment of Psychiatry, University of Pennsylvania School of MedicineMental Illness Research, Education, and Clinical Center of the Veterans Integrated Service Network 4, Crescenz Veterans Affairs Medical CenterLeonard Davis Institute of Health Economics, University of PennsylvaniaAbstract Background Primary care is an ideal setting to connect individuals at risk for suicide to follow-up care; however, only half of the patients referred from the primary care attend an initial mental health visit. We aim to develop acceptable, feasible, low-cost, and effective new strategies to increase treatment initiation among at-risk individuals identified in primary care. Methods We will conduct a multi-phase, mixed-methods study. First, we will conduct a chart review study by using administrative data, including medical records, to identify characteristics of primary care patients at risk for suicide who do or do not attend an initial mental health visit following a referral. Second, we will conduct a mixed methods study by using direct observations and qualitative interviews with key stakeholders (N = 65) to understand barriers and facilitators to mental health service initiation among at-risk individuals. Stakeholders will include patients with suicidal ideation referred from primary care who do and do not attend a first mental health visit, primary care and behavioral health providers, and individuals involved in the referral process. We also will collect preliminary self-report and behavioral data regarding potential mechanisms of behavior change (i.e., self-regulation and social support) from patients. Third, we will leverage these findings, relevant frameworks, and the extant literature to conduct a multi-arm, non-randomized feasibility trial. During this trial, we will rapidly prototype and test strategies to support attendance at initial mental health visits. Strategies will be developed with subject matter experts (N = 10) and iteratively pilot tested (~5 patients per strategy) and refined. Research will be completed in the Penn Integrated Care Program (PIC), which includes fourteen primary care clinics in Philadelphia that provide infrastructure for electronic referrals, patient communication, and data access. Discussion We will leverage frameworks and methods from behavioral economics and implementation science to develop strategies to increase mental health treatment initiation among individuals at risk for suicide identified in primary care. This project will lead to an evaluation of these strategies in a fully powered randomized trial and contribute to improvements in access to and engagement in mental health services for individuals at risk for suicide. Trial registration ClinicalTrials.gov Identifier: NCT05021224https://doi.org/10.1186/s40814-022-01131-ySuicideImplementationTreatment engagementTreatment initiationBehavioral economicsScience of behavior change |
| spellingShingle | Gabriela Kattan Khazanov Shari Jager-Hyman Joseph Harrison Molly Candon Alison Buttenheim Matteo F. Pieri David W. Oslin Courtney Benjamin Wolk Leveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment: a pilot study protocol Pilot and Feasibility Studies Suicide Implementation Treatment engagement Treatment initiation Behavioral economics Science of behavior change |
| title | Leveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment: a pilot study protocol |
| title_full | Leveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment: a pilot study protocol |
| title_fullStr | Leveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment: a pilot study protocol |
| title_full_unstemmed | Leveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment: a pilot study protocol |
| title_short | Leveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment: a pilot study protocol |
| title_sort | leveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment a pilot study protocol |
| topic | Suicide Implementation Treatment engagement Treatment initiation Behavioral economics Science of behavior change |
| url | https://doi.org/10.1186/s40814-022-01131-y |
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