# Optimizing Suicide Prevention Strategies for Pediatric Primary Care

> **NIH NIH R34** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2024 · $230,576

## Abstract

PROJECT SUMMARY/ABSTRACT
This proposal responds to the youth suicide crisis by optimizing a suicide prevention intervention delivery
strategy that is feasible, acceptable, and scalable in pediatric primary care (PPC). Although PPC providers
routinely identify at-risk youth, no suicide prevention intervention is suited for the immediate, in-office delivery
that this clinical situation demands. In our prior work, we developed and tested the effectiveness of an integrated
adolescent suicide prevention intervention, iCHART (integrated Care to Help At-Risk Teens), in a controlled,
academic PPC setting that relied on behavioral health (BH) providers. iCHART consists of: 1) Screening Wizard,
a web-based enhanced screener to aid PPC providers in treatment decisions; 2) BRITE, an app-supported
intervention that guides youth in developing a personalized, smartphone-based safety plan; and 3)
Text2Connect, an automated texting intervention that motivates youth to follow providers’ recommendations.
The original version of iCHART components showed feasibility, usability, and acceptability across youth, parents,
and providers and preliminary effectiveness in enhancing BH referral, referral follow-through, and decreasing
depression. However, a critical gap remains in equipping front line pediatricians, who generally lack access to
onsite BH providers, with suicide prevention intervention strategies that are feasible, usable, and acceptable for
their workflows and in their setting. This proposal aims to address this gap through the development of a
computerized version of As Safe As Possible (cASAP) to deliver aspects of the iCHART intervention that required
BH support (i.e., psychoeducation about safety planning, cognitive-behavioral skills to cope with distress, and
facilitate collaboration with parents). In the proposed study, we will partner with the American Academy of
Pediatrics (AAP) national PPC practice-based research network, Pediatric Research in Office Settings (PROS)
to develop and test a version of iCHART that can be provided in the PPC setting without onsite BH providers,
termed iCHART-cASAP. In this proposal, we will draw upon our extensive expertise in human-computer
interaction (HCI) methods and user studies with youth, parents, and PPC providers, to inform the technology
design of a computerized version of ASAP (cASAP) to provide youth and parents information about safety
planning, cognitive behavioral skills to cope with distress, and parent communication with youth about their
mental health. We will then conduct a stepped wedge pilot randomized trial with 60 youth aged 12-17 at risk for
suicide (past month suicide ideation/attempt) identified in PPC. We will compare iCHART-cASAP to usual care
and the impact on depression and suicide risk at 1-, 3-, and 6-month follow-up. Following the pilot trial, we will
conduct a mixed methods study with PPC providers to develop an accompanying implementation strategy. Our
findings will inform a future, ful...

## Key facts

- **NIH application ID:** 10871867
- **Project number:** 5R34MH132932-02
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** STEPHANIE D STEPP
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $230,576
- **Award type:** 5
- **Project period:** 2023-06-19 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10871867

## Citation

> US National Institutes of Health, RePORTER application 10871867, Optimizing Suicide Prevention Strategies for Pediatric Primary Care (5R34MH132932-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10871867. Licensed CC0.

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