# Scaling up eConnect in Juvenile Probation Settings: a hybrid implementation-effectiveness trial of a digital suicide risk/behavior identification and linkage-to-treatment system

> **NIH NIH R01** · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · 2024 · $1,408,187

## Abstract

Among US adolescents, suicide is the second leading cause of death1. Suicide risk is not uniform across youth,
and those involved in the juvenile justice (JJ) system are at even greater risk for suicidal behavior (SB) given
their increased prevalence of mood and substance use disorders, trauma exposure, and access to firearms.
While SB screening and service provision for youth in secure JJ settings occurs more systematically, such
practices are rarer for youth who are supervised in their community (i.e., probation settings). The proposed study
will examine strategies to bolster the successful scale-up of e-Connect, one of the few evidence-based suicide
behavior identification and cross-system linkage programs for youth on under community supervision. This
proposal is from two PIs with complimentary expertise in the justice system, implementation science, clinical
decision support systems, and use of large administrative data sets, and is supported by a strong multi-
disciplinary team to achieve study aims. Guided by the Gateway Provider Model (GPM) and the Exploration,
Preparation, Implementation Sustainment (EPIS) implementation framework, we now propose to extend ourwork
of e-Connect, to develop and test a “purveyor model” of implementation scale-up (i.e., e-Connect-scaleup). In e-
Connect-scaleup, researchteamleadershipwill serveas External Facilitatorsto support Local Facilitators to ensure
the successful transfer of knowledge, skill and expertise in delivering e-Connect in a new JJ system and
geographic context, utilizing implementation strategies to support the more widespread, sustained and rigorous
adoption of e-Connect. Working in 9 Indiana counties, randomly assigned to one of three waves in a stepped-
wedge, implementation-effectivenesshybrid type-2 design
,the specificaims are to
examine the clinical and cost-
effectiveness of e-Connect-scaleup on (i) identification of youth service need (SB and BH correlates) in juvenile
probationers; (ii) cross-system (probation-BH agency) referral; and (iii) youth BH service use (initial BH contact;
primary outcome) by comparing the performance of e-Connect to (a) standard probation officer practice
(baseline) and (b) to rates achieved in the prior efficacy trial of e-Connect (Aim 1). We will examine potential
mediating or moderating effects of EPIS/GPM inner and outer context factors. We will also determine whether
e-Connect-scaleup can reduce race or gender health disparities in SB/BH service need identification, cross-
system referral and youth SB/BH service use (e.g. as compared to standard probation practice (baseline), which
would replicate the disparity-reducing performance of e-Connect in NYS (Aim 2). Finally, we will examine the
implementation of e-Connect-scaleup in terms of fidelity and acceptability and compare advancement through
the stages of implementation through to sustainment across the 9 counties in order to demonstrate the feasibility
of scaling-up e-Connect in probation setting...

## Key facts

- **NIH application ID:** 10686314
- **Project number:** 5R01MH130845-02
- **Recipient organization:** NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
- **Principal Investigator:** Matthew Aalsma
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,408,187
- **Award type:** 5
- **Project period:** 2022-09-01 → 2028-09-09

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10686314

## Citation

> US National Institutes of Health, RePORTER application 10686314, Scaling up eConnect in Juvenile Probation Settings: a hybrid implementation-effectiveness trial of a digital suicide risk/behavior identification and linkage-to-treatment system (5R01MH130845-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10686314. Licensed CC0.

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