# Developing an Adaptive Intervention for Suicidal Adolescents Following Inpatient Hospitalization:  A Pilot SMART

> **NIH NIH K23** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $193,352

## Abstract

ABSTRACT
This 4-year K23 Mentored Career Development Award application proposes a program of focused research
and training to facilitate the applicant's transition to an independent career in patient-oriented research with a
specialization in adaptive and technology-enhanced interventions for youth at risk for suicide. CONTEXT:
Despite the public health significance of youth suicide, efficacious interventions for suicidal teens are lacking.
In particular, a critical need exists for effective interventions for psychiatrically hospitalized adolescents who
are at a high risk for repeated suicidal behavior and related crises. Because suicidal youth are highly
heterogeneous in terms of varying levels of post-discharge suicide risk and response to intervention, optimizing
post-discharge outcomes (preventing relapse of suicidal crises) requires a personalized approach. Adaptive
interventions (AIs), which can individualize the type, intensity, and timing of treatment, are ideally suited for
addressing this heterogeneity. In addition, given the ubiquity and youth preferences for mobile communication
(text messaging), integrating technology to augment interventions for suicidal youth can potentially strengthen
their impact. RESEARCH STRATEGY: To inform the development of a technology-augmented AI for suicidal
teens, the applicant proposes to conduct a Sequential, Multiple Assignment, Randomized Trial (SMART) pilot
of a Motivational Interview (MI)-enhanced safety planning intervention (MI-SafeCope). Building on the
applicant's pilot research, Aim 1 will focus on finalizing the intervention components (MI-enhanced safety plan
delivered at hospitalization; post-discharge daily text message boosters; post-discharge telephone booster
call), implementation protocol, and fidelity assessment tools in preparation for the SMART pilot. Specifically,
the applicant will develop the text message booster component through a process of iterative refinement based
on feedback from experts and adolescent focus groups (N=20). Aim 2 will focus on conducting the SMART
pilot (N=80) with suicidal adolescent inpatients (ages 13-17) to refine and demonstrate acceptability and
feasibility of study procedures and MI-SafeCope components and their sequence to guide the implementation
of a full-scale SMART (R01 proposal). The full-scale SMART will, in turn, lead to the construction of the AI for
suicidal teens following acute care. TRAINING PLAN: To facilitate the applicant's career goal of becoming an
independent clinical scientist developing interventions to prevent youth suicide, the specific training goals are
to: (1) gain expertise in intervention science with a focus on developing, implementing, and evaluating AIs for
youth at risk for suicide; (2) develop skills in integrating technology to augment and deliver interventions for
these youth; and (3) obtain training in analytic strategies for SMART studies and analytic approaches that can
inform the development of AIs. These goals ...

## Key facts

- **NIH application ID:** 10005463
- **Project number:** 5K23MH113776-04
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Ewa Karina Czyz
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $193,352
- **Award type:** 5
- **Project period:** 2017-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005463

## Citation

> US National Institutes of Health, RePORTER application 10005463, Developing an Adaptive Intervention for Suicidal Adolescents Following Inpatient Hospitalization:  A Pilot SMART (5K23MH113776-04). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10005463. Licensed CC0.

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