دورية أكاديمية
أعرض في EDS

Ethical and methodological challenges slowing progress in primary care-based suicide prevention: Illustrations from a randomized controlled trial and guidance for future research.

التفاصيل البيبلوغرافية
العنوان: Ethical and methodological challenges slowing progress in primary care-based suicide prevention: Illustrations from a randomized controlled trial and guidance for future research.
المؤلفون: Jerant A; Department of Family and Community Medicine, University of California (UC) Davis School of Medicine, USA. Electronic address: afjerant@ucdavis.edu., Duberstein PR; Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, USA., Kravitz RL; Division of General Medicine, Department of Internal Medicine, UC Davis School of Medicine, USA., Kleiman EM; Department of Psychology, School of Arts and Sciences, Rutgers University, USA., Rizvi SL; Department of Clinical Psychology, Graduate School of Applied and Professional Psychology, Rutgers University, USA., Cipri C; Center for Healthcare Policy and Research, UC Davis, USA., Liu D; Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, USA., Scher L; Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, USA., Freitas M; M. Freitas Therapy, Rocklin, CA, USA., Jones-Hill M; MHJ Therapy and Associates, Sacramento, CA, USA., Oravetz A; Center for Healthcare Policy and Research, UC Davis, USA., Van Orden KA; Department of Psychiatry, University of Rochester School of Medicine and Dentistry, USA., Franks P; Department of Family and Community Medicine, University of California (UC) Davis School of Medicine, USA.
المصدر: Journal of psychiatric research [J Psychiatr Res] 2022 Oct; Vol. 154, pp. 242-251. Date of Electronic Publication: 2022 Aug 06.
نوع المنشور: Journal Article; Randomized Controlled Trial
اللغة: English
بيانات الدورية: Publisher: Pergamon Press Country of Publication: England NLM ID: 0376331 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1379 (Electronic) Linking ISSN: 00223956 NLM ISO Abbreviation: J Psychiatr Res Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford : Pergamon Press
مواضيع طبية MeSH: Suicide Prevention*, Adult ; Ethics Committees, Research ; Humans ; Male ; Middle Aged ; Primary Health Care ; Research Design ; Suicidal Ideation
مستخلص: Introduction: Despite the pressing need for primary care-based suicide prevention initiatives and growing acknowledgement of recruitment difficulties and Institutional Review Board (IRB) challenges in suicide research, we are aware of no illustrative examples describing how IRB decisions in the design of a primary care trial can compound recruitment challenges.
Methods: The CDC-funded trial (NCT02986113) of Men and Providers Preventing Suicide aimed to examine the effects of a tailored computer program encourage men with suicidal thoughts (n = 304, ages 35-64) to discuss suicide with a primary care clinician and accept treatment. Before a visit, participants viewed MAPS or a non-tailored control video. Post-visit, both arms were offered telephone collaborative care, as mandated by the institutional review board (IRB). We previously showed that exposure to MAPs led to improvements in communication about suicide in a primary care visit. In this paper, we report data on the study's primary outcome, suicide preparatory behaviors.
Results: After screening nearly 4100 men, 48 enrolled. Recruitment challenges, which were exacerabted by an IRB mandate narrowing post-intervention patient management differences between trial arms, limited detection of the effects of MAPS on suicide preparatory behaviors.
Conclusions: While primary care settings are key sites for suicide prevention trials, issues such as recruitment difficulties and overly restrictive IRB requirements may limit their utility. Methodological innovation to improve recruitment and ethical guidance to inform IRB decision-making are needed.
(Copyright © 2022 Elsevier Ltd. All rights reserved.)
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معلومات مُعتمدة: U01 CE002664 United States CE NCIPC CDC HHS; U01CE002664 United States ACL ACL HHS
فهرسة مساهمة: Keywords: Help-seeking behavior; Institutional review board; Men's health; Patient activation; Physician-patient relations; Primary care; Research ethics; Suicide; Tailored interventions
سلسلة جزيئية: ClinicalTrials.gov NCT02986113
تواريخ الأحداث: Date Created: 20220812 Date Completed: 20220919 Latest Revision: 20230426
رمز التحديث: 20230426
مُعرف محوري في PubMed: PMC10124132
DOI: 10.1016/j.jpsychires.2022.07.038
PMID: 35961180
قاعدة البيانات: MEDLINE
الوصف
تدمد:1879-1379
DOI:10.1016/j.jpsychires.2022.07.038