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Acceptability and Feasibility of a Smartphone-Based Real-Time Assessment of Suicide Among Black Men: Mixed Methods Pilot Study

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posted on 2024-02-26, 00:58 authored by Leslie B Adams, Thomasina Watts, Aubrey DeVinney, Emily E Haroz, Johannes ThrulJohannes Thrul, Jasmin Brooks Stephens, Mia N Campbell, Denis Antoine, Benjamin Lê Cook, Sean Joe, Roland J Thorpe
Background: Suicide rates in the United States have increased recently among Black men. To address this public health crisis, smartphone-based ecological momentary assessment (EMA) platforms are a promising way to collect dynamic, real-time data that can help improve suicide prevention efforts. Despite the promise of this methodology, little is known about its suitability in detecting experiences related to suicidal thoughts and behavior (STB) among Black men. Objective: This study aims to clarify the acceptability and feasibility of using smartphone-based EMA through a pilot study that assesses the user experience among Black men. Methods: We recruited Black men aged 18 years and older using the MyChart patient portal messaging (the patient-facing side of the Epic electronic medical record system) or outpatient provider referrals. Eligible participants self-identified as Black men with a previous history of STB and ownership of an Android or iOS smartphone. Eligible participants completed a 7-day smartphone-based EMA study. They received a prompt 4 times per day to complete a brief survey detailing their STB, as well as proximal risk factors, such as depression, social isolation, and feeling like a burden to others. At the conclusion of each day, participants also received a daily diary survey detailing their sleep quality and their daily experiences of everyday discrimination. Participants completed a semistructured exit interview of 60-90 minutes at the study’s conclusion. Results: In total, 10 participants completed 166 EMA surveys and 39 daily diary entries. A total of 4 of the 10 participants completed 75% (21/28) or more of the EMA surveys, while 9 (90%) out of 10 completed 25% (7/28) or more. The average completion rate of all surveys was 58% (20.3/35), with a minimum of 17% (6/35) and maximum of 100% (35/35). A total of 4 (40%) out of 10 participants completed daily diary entries for the full pilot study. No safety-related incidents were reported. On average, participants took 2.08 minutes to complete EMA prompts and 2.72 minutes for daily diary surveys. Our qualitative results generally affirm the acceptability and feasibility of the study procedures, but the participants noted difficulties with the technology and the redundancy of the survey questions. Emerging themes also addressed issues such as reduced EMA survey compliance and diminished mood related to deficit-framed questions related to suicide. Conclusions: Findings from this study will be used to clarify the suitability of EMA for Black men. Overall, our EMA pilot study demonstrated mixed feasibility and acceptability when delivered through smartphone-based apps to Black men. Specific recommendations are provided for managing safety within these study designs and for refinements in future intervention and implementation science research.

Funding

LBA was supported by a grant from the Bloomberg American Health Initiative at Johns Hopkins Bloomberg School of Public Health, from the National Institutes on Mental Health (K01MH127310) and the American Foundation on Suicide Prevention (YIG-0-001-19). RJTJ was supported by grants National Institutes of Health (K02AG059140) and (U54MD000214). EEH was supported through the National Institutes on Mental Health (K01MH226335). The MyChart Recruitment Service is a service supported by the Johns Hopkins Institute for Clinical and Translation Research. The Johns Hopkins Institute for Clinical and Translation Research is funded by the National Center for Advancing Translational Sciences through the Clinical & Translational Science Awards Program.

History

Publication Date

2024-01-22

Journal

JMIR Formative Research

Volume

8

Issue

1

Article Number

e48992

Pagination

12p.

Publisher

JMIR Publications Inc.

ISSN

2561-326X

Rights Statement

© Leslie B Adams, Thomasina Watts, Aubrey De Vinney, Emily E Haroz, Johannes Thrul, Jasmin Brooks Stephens, Mia N Campbell, Denis Antoine, Benjamin Lê Cook, Sean Joe, Roland J Thorpe Jr. Originally published in JMIR Formative Research (https://formative.jmir.org), 22.01.2024. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.