A Just-in-time Adaptive Intervention for Suicide Safety Planning in Adolescents

Proximal Engagement

Engagement with the ViraSafe app (i.e., tapping on the push notification, patterns of accessing app features such as coping skills and safety plan) and BRITE app (daily dose rating, post rating after accessing coping skill, editing coping skill content)

Engagement with the apps

Engagement over the course of the trial will be measured through objective app usage metrics, including total number and frequency of features used.

Technology Acceptance

Mixed methods feedback on acceptability, usability, and satisfaction, including the System Usability Scale and items adapted from the Technology Acceptance Model (TAM). System Usability Scale: 10 items -- Brooke, J(1996) Technology Acceptance Model: 12 Items - Adapted from Davis, (1989) Participants rate the extent to which they agree with each statement by circling a number from one to seven arranged horizontally beneath anchor point descriptions "Strongly Agree," "Neutral," and "Strongly Disagree.

Suicide Risk Factors: Columbia Suicide Severity Rating Scale (CSSRS)

Changes in suicide risk factors from baseline to 3 months assessed through the Columbia Suicide Severity Rating Scale (CSSRS). The C-SSRS is an assessment of suicidal thoughts and behaviors in clinical and research settings. The C-SSRS consists of 16 questions about suicidal thoughts and behaviors (the first 10 questions comprise the ideation subscale and the last 6 comprise the behavior subscale). This 5-item subscale ranges from a minimum of 0 (corresponding to no suicidal ideation) to a maximum of 5 (representing active suicidal ideation with plan and intent).

Suicidal Risk Factors: Reason for Living

The Reasons for Living (RFL) Inventory is a 48-item instrument that measures a range of beliefs potentially important as reasons for not committing suicide. The items are rated on 6-point Likert type scales based on how important each reason would be for living if suicide was contemplated (1 = not at all important; 6 = extremely important). The total score is calculating by calculating the mean of the item scores and multiplying the result by 48. Total scores can only be calculated if a participant answers at least 38 items.

Depressive Symptoms: Mood and Feelings Questionnaire (MFQ)

Changes in self-reported depressive symptoms from baseline to 3 months, assessed through the Mood and Feelings Questionnaire (MFQ). The MFQ is a 13-item self-report questionnaire used to screen for depressive in children and young people. Items are rated on a 3-point Likert scale (not true = 0; sometimes true = 1; not true = 2). Scores are calculated by summing the point values on each response. Total MFQ scores range from 0 to 26, with higher scores suggesting greater severity in depressive symptoms.

Anxiety Symptoms: the Screen for Anxiety Related Emotional Disorders (SCARED)

Changes in self-reported anxiety symptoms from baseline to 3 months, assessed through the Screen for Anxiety Related Emotional Disorders (SCARED) The SCARED is a 5-item self-report questionnaire used to screen for childhood anxiety disorders including general anxiety disorder, separate anxiety disorder, panic disorder, and social phobia. Items are rated on a 3-point Likert scale from 0 to 2 and summed to yield a total score. Total scores range from 0 to 10. Higher scores indicate greater anxiety.