Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial
ObjectivesRates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver thera...
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| Veröffentlicht in: | BMJ open 2017-01, Vol.7 (1), p.e013518 |
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| creator | Tighe, Joseph Shand, Fiona Ridani, Rebecca Mackinnon, Andrew De La Mata, Nicole Christensen, Helen |
| description | ObjectivesRates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia.SettingRemote and very remote communities in the Kimberley region of North Western Australia.ParticipantsIndigenous Australians aged 18–35 years.Interventions61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks.Primary and secondary outcome measuresThe primary outcome was the Depressive Symptom Inventory—Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11).ResultsAlthough preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use.ConclusionsApps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via appropriately designed self-help apps.Trial registration numberACTRN12613000104752. |
| doi_str_mv | 10.1136/bmjopen-2016-013518 |
| format | Article |
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Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia.SettingRemote and very remote communities in the Kimberley region of North Western Australia.ParticipantsIndigenous Australians aged 18–35 years.Interventions61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks.Primary and secondary outcome measuresThe primary outcome was the Depressive Symptom Inventory—Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11).ResultsAlthough preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use.ConclusionsApps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via appropriately designed self-help apps.Trial registration numberACTRN12613000104752.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2016-013518</identifier><identifier>PMID: 28132007</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adolescent ; Adult ; Australian Aboriginal and Torres Strait Islander Peoples ; Collaboration ; Community ; Depression - psychology ; Depression - therapy ; Evidence-based medicine ; Female ; Health services ; Health Services - statistics & numerical data ; Humans ; Impulsive Behavior ; Intervention ; Male ; Medical personnel ; Mental disorders ; Mental Health ; Mental health care ; Middle Aged ; Mobile Applications ; Native North Americans ; Pilot Projects ; Population ; Prevention ; Public health ; Questionnaires ; Schizophrenia ; Self destructive behavior ; Self-Management ; Smartphones ; Social networks ; Stress, Psychological - psychology ; Stress, Psychological - therapy ; Suicidal Ideation ; Suicide Prevention ; Suicides & suicide attempts ; Telemedicine ; Western Australia ; Young Adult</subject><ispartof>BMJ open, 2017-01, Vol.7 (1), p.e013518</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2017 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b501t-a29615227f6e7e597811ff1f2ed6491fc11591eb2bf3e124c4ce805df6ff68383</citedby><cites>FETCH-LOGICAL-b501t-a29615227f6e7e597811ff1f2ed6491fc11591eb2bf3e124c4ce805df6ff68383</cites><orcidid>0000-0003-3553-6721</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/7/1/e013518.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/7/1/e013518.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27540,27541,27915,27916,53782,53784,77362,77393</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28132007$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tighe, Joseph</creatorcontrib><creatorcontrib>Shand, Fiona</creatorcontrib><creatorcontrib>Ridani, Rebecca</creatorcontrib><creatorcontrib>Mackinnon, Andrew</creatorcontrib><creatorcontrib>De La Mata, Nicole</creatorcontrib><creatorcontrib>Christensen, Helen</creatorcontrib><title>Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectivesRates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia.SettingRemote and very remote communities in the Kimberley region of North Western Australia.ParticipantsIndigenous Australians aged 18–35 years.Interventions61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks.Primary and secondary outcome measuresThe primary outcome was the Depressive Symptom Inventory—Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11).ResultsAlthough preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use.ConclusionsApps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via appropriately designed self-help apps.Trial registration numberACTRN12613000104752.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Australian Aboriginal and Torres Strait Islander Peoples</subject><subject>Collaboration</subject><subject>Community</subject><subject>Depression - psychology</subject><subject>Depression - therapy</subject><subject>Evidence-based medicine</subject><subject>Female</subject><subject>Health services</subject><subject>Health Services - statistics & numerical data</subject><subject>Humans</subject><subject>Impulsive Behavior</subject><subject>Intervention</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Mental disorders</subject><subject>Mental Health</subject><subject>Mental health care</subject><subject>Middle Aged</subject><subject>Mobile Applications</subject><subject>Native North Americans</subject><subject>Pilot Projects</subject><subject>Population</subject><subject>Prevention</subject><subject>Public health</subject><subject>Questionnaires</subject><subject>Schizophrenia</subject><subject>Self destructive behavior</subject><subject>Self-Management</subject><subject>Smartphones</subject><subject>Social networks</subject><subject>Stress, Psychological - psychology</subject><subject>Stress, Psychological - therapy</subject><subject>Suicidal Ideation</subject><subject>Suicide Prevention</subject><subject>Suicides & suicide attempts</subject><subject>Telemedicine</subject><subject>Western Australia</subject><subject>Young Adult</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNUU1rGzEQFaWlCW5-QaEIeullU4202o8eCiG0jSHQS3sW2t1RLKOVXEkb8CH_vTJ2QppTB8EMmvce83iEvAd2CSCaz8O8DTv0FWfQVAyEhO4VOeesrquGSfn62XxGLlLaslK17KXkb8kZ70Bwxtpz8rAewjC4PZ3DYB3SDWqXN9T6jPEefbbBUxMiTYsd7YR0F_Hx23p6taQctbPa07Wf7B36sCS6D0vefKGa7qwLmUbtpzDbhBMdg88xOFfGHK1278gbo13Ci1Nfkd_fv_26vqluf_5YX1_dVoNkkCvN-wYk561psEXZtx2AMWA4Tk3dgxkBZA848MEIBF6P9Ygdk5NpjGk60YkV-XrU3S3DjNNYHJSz1S7aWce9CtqqfzfebtRduFeSt115ReDTSSCGPwumrIqhEZ3THotlBV3De9ELfoB-fAHdhiX6Yk9BL1jNBS99RcQRNcaQUkTzdAwwdUhYnRJWh4TVMeHC-vDcxxPnMc8CuDwCCvu_FP8C7z61JQ</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Tighe, Joseph</creator><creator>Shand, Fiona</creator><creator>Ridani, Rebecca</creator><creator>Mackinnon, Andrew</creator><creator>De La Mata, Nicole</creator><creator>Christensen, Helen</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3553-6721</orcidid></search><sort><creationdate>20170101</creationdate><title>Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial</title><author>Tighe, Joseph ; Shand, Fiona ; Ridani, Rebecca ; Mackinnon, Andrew ; De La Mata, Nicole ; Christensen, Helen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b501t-a29615227f6e7e597811ff1f2ed6491fc11591eb2bf3e124c4ce805df6ff68383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Australian Aboriginal and Torres Strait Islander Peoples</topic><topic>Collaboration</topic><topic>Community</topic><topic>Depression - psychology</topic><topic>Depression - therapy</topic><topic>Evidence-based medicine</topic><topic>Female</topic><topic>Health services</topic><topic>Health Services - statistics & numerical data</topic><topic>Humans</topic><topic>Impulsive Behavior</topic><topic>Intervention</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Mental disorders</topic><topic>Mental Health</topic><topic>Mental health care</topic><topic>Middle Aged</topic><topic>Mobile Applications</topic><topic>Native North Americans</topic><topic>Pilot Projects</topic><topic>Population</topic><topic>Prevention</topic><topic>Public health</topic><topic>Questionnaires</topic><topic>Schizophrenia</topic><topic>Self destructive behavior</topic><topic>Self-Management</topic><topic>Smartphones</topic><topic>Social networks</topic><topic>Stress, Psychological - psychology</topic><topic>Stress, Psychological - therapy</topic><topic>Suicidal Ideation</topic><topic>Suicide Prevention</topic><topic>Suicides & suicide attempts</topic><topic>Telemedicine</topic><topic>Western Australia</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tighe, Joseph</creatorcontrib><creatorcontrib>Shand, Fiona</creatorcontrib><creatorcontrib>Ridani, Rebecca</creatorcontrib><creatorcontrib>Mackinnon, Andrew</creatorcontrib><creatorcontrib>De La Mata, Nicole</creatorcontrib><creatorcontrib>Christensen, Helen</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database (ProQuest)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tighe, Joseph</au><au>Shand, Fiona</au><au>Ridani, Rebecca</au><au>Mackinnon, Andrew</au><au>De La Mata, Nicole</au><au>Christensen, Helen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>7</volume><issue>1</issue><spage>e013518</spage><pages>e013518-</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectivesRates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia.SettingRemote and very remote communities in the Kimberley region of North Western Australia.ParticipantsIndigenous Australians aged 18–35 years.Interventions61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks.Primary and secondary outcome measuresThe primary outcome was the Depressive Symptom Inventory—Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11).ResultsAlthough preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use.ConclusionsApps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via appropriately designed self-help apps.Trial registration numberACTRN12613000104752.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>28132007</pmid><doi>10.1136/bmjopen-2016-013518</doi><orcidid>https://orcid.org/0000-0003-3553-6721</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Electronic Journals Library; BMJ Open Access Journals; Open Access: PubMed Central; MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access |
| subjects | Adolescent Adult Australian Aboriginal and Torres Strait Islander Peoples Collaboration Community Depression - psychology Depression - therapy Evidence-based medicine Female Health services Health Services - statistics & numerical data Humans Impulsive Behavior Intervention Male Medical personnel Mental disorders Mental Health Mental health care Middle Aged Mobile Applications Native North Americans Pilot Projects Population Prevention Public health Questionnaires Schizophrenia Self destructive behavior Self-Management Smartphones Social networks Stress, Psychological - psychology Stress, Psychological - therapy Suicidal Ideation Suicide Prevention Suicides & suicide attempts Telemedicine Western Australia Young Adult |
| title | Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial |
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