Suicidal behaviors (ideation, planning, attempts) and non-suicidal self-injurious behaviors (NSSI) are highly prevalent among juvenile justice-involved transition-age (TA) youth. More than half of youth in the juvenile justice (JJ) system report suicidal ideation; one-third report a history of suicidal behavior. Black youth are disproportionately represented in juvenile justice and are also at increased risk of suicide, as rates of suicidal behavioral and death by suicide among Black youth have risen at an alarming rate, faster than other racial/ethnic groups. This increase has resulted in a number of government initiatives to increase suicide prevention efforts for Black youth. Reducing suicide risk among JJ-involved youth must occur in conjunction with interventions addressing their broader needs for reduced externalizing behavior and in ways that are culturally appropriate for Black youth. iKinnect is a paired mobile app platform that supports parents (in delivering) and youth (in receiving) evidence-based practices to reduce youth problem behaviors. Based on Multisystemic Therapy principles, iKinnect1.0 was originally designed to help youth with serious conduct problems. Results from a randomized controlled trial (RCT; N=72) demonstrated its efficacy in reducing externalizing behaviors and improving parent effectiveness. This fast-track proposal seeks to significantly expand iKinnect to prevent NSSI, suicidal behaviors (ideation, planning, attempts), and death by suicide in JJ-involved TA youth while continuing to decrease externalizing behaviors and prevent recidivism. Leaders in the area of suicide risk among Black youth and cultural appropriateness of interventions will guide these efforts. This 33-month fast track will include three primary phases of evaluation: (1) a proof-of-concept formative evaluation phase during which we will iteratively design, test, and build a central portion of iKinnect2.0 to achieve its usability, acceptability, and relevance (Months 1-10); (2) a product design-and-build formative evaluation phase, where we will design, build, and test all remaining features for iOS and Android phones, while also preparing the platform for clinical use (Months 11-23); and (3) a summative evaluation phase involving a pilot test (N=15) of iKinnect2.0 and an RCT (N=120) comparing iKinnect2.0 to an active control condition; and results will then be analyzed, reported, and disseminated (Months 24-33). We predict that iKinnect2.0 TA youth and parents will report a significantly greater decrease in suicidal and NSSI behaviors and in conduct problem behaviors in TA youth. Furthermore, iKinnect2.0 participants (TA youth and parents) will report significantly greater use of behavioral skills, as well as self-efficacy in coping with emotional distress and other challenging situations. iKinnect2.0 parents will report greater awareness of and confidence in applying evidence-based strategies to prevent suicide/NSSI and support their suicidal youth through a suicide crisis.
Public Health Relevance Statement: PUBLIC HEALTH STATEMENT Non-suicidal self-injurious behaviors (NSSI) and suicidal behaviors (ideation, planning, attempts) are highly prevalent among juvenile justice-involved youth. Rates of suicidal behavior and death by suicide among Black youth, who are disproportionately involved in the juvenile justice system, have also risen at an alarming rate, resulting in a number of government initiatives to increase suicide prevention interventions for Black youth that are culturally-appropriate. This proposed iKinnect2.0 Fast-Track seeks to significantly expand iKinnect, an efficacious paired mobile app that supports parents (in delivering) and youth (in receiving) evidence-based techniques to reduce youth externalizing behaviors such as delinquency and drug use. iKinnect2.0 will be expanded to also prevent NSSI, suicidal behaviors, and death by suicide in juvenile justice-involved youth while continuing to prevent criminal recidivism.
Project Terms: Adult; 21+ years old; Adult Human; adulthood; Age; ages; Awareness; Behavior; Ethnic group; Ethnic People; Ethnic Population; Ethnicity People; Ethnicity Population; ethnicity group; Family; Gold; Government; Recording of previous events; History; Justice; Movement; body movement; Parents; Public Health; Resources; Research Resources; Suicide; fatal attempt; fatal suicide; intent to die; suicidality; Technology; Testing; Self-Injurious Behavior; Deliberate Self-Harm; deliberate self harm; intentional self harm; intentional self injury; self harm; self injury; Administrator; Research Methodology; Research Methods; Youth; Youth 10-21; base; improved; Procedures; Suicide prevention; Suicide precaution; prevent suicidality; prevent suicide; suicidality prevention; suicide intervention; Area; Acute; Clinical; Phase; Adolescent; Adolescent Youth; juvenile; juvenile human; Death Rate; Ensure; Evaluation; insight; Recovery; Drug usage; drug use; Problem behavior; behavioral problem; Randomized Controlled Trials; ideation; Suicidal thoughts; suicidal ideation; suicidal thinking; suicide ideation; thoughts about suicide; Feeling suicidal; suicidal; Techniques; Services; skills training; Emergency Department; Emergency room; Accident and Emergency department; suicide risk; suicidal risk; experience; Self Efficacy; skills; Participant; Preventative strategy; Preventive strategy; Prevention strategy; recidivism; probation; Reporting; feeling distress; feeling upset; emotional distress; Social Support System; Support System; psychoeducation; Intervention Strategies; interventional strategy; Intervention; Effectiveness; preventing; prevent; Address; Evidence based practice; Preventative intervention; intervention for prevention; prevention intervention; preventional intervention strategy; preventive intervention; Process; Development; developmental; Behavioral; active control; Evidence based treatment; suicidal behavior; suicide behavior; digital; design; designing; suicidal morbidity; suicide death; suicide morbidity; youth conduct problem; externalizing behavior; coping; juvenile justice system; racial and ethnic; ethnoracial; suicidal adolescent; suicidal youth; user centered design; usability; iterative design; evidence base; reducing suicide; reduce suicidality; reduce suicide; reducing suicidality; conduct problem; mobile application; mobile app; mobile device application; formative assessment; formative evaluation; Android; recruit; smartphone Application; Android App; Android Application; Cell Phone Application; Cell phone App; Cellular Phone App; Cellular Phone Application; Smart Phone App; Smart Phone Application; Smartphone App; iOS app; iOS application; iPhone App; iPhone Application