The Adolescent Suicide Prevention in Routine clinical Encounters (ASPIRE) trial

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Dr. Kristin Linn, Assistant Professor of Biostatistics, has been awarded a supplement to an R01 led by Dr. Rinad Beidas, Chair and Ralph Seal Paffenbarger Professor of Medical Social Sciences at Northwestern University. The primary goal of the parent R01, the Adolescent Suicide Prevention in Routine clinical Encounters (ASPIRE) trial, is to compare the effectiveness of an electronic health record (EHR) nudge alone to an EHR nudge plus facilitation with respect to delivery of a secure firearm storage program during pediatric well-child visits. The research team captured clinician-reported reach in the EHR for the entire patient population (~45,000 visits) and obtained fidelity (i.e., parent-reported receipt of the program) from a subset of parents with whom we engaged in an intensive sampling approach to collect a post-visit survey. Reach was documented by clinicians for a large sample of patients and therefore does not suffer from the potential non-response bias that may affect parent-reported fidelity. However, reach may suffer from measurement error if clinicians incorrectly reported program delivery or exited out of the EHR prompt without responding to the questions. The proposed aims of Dr. Linn’s supplement will develop statistical methods to combine information contained in each outcome (reach, fidelity), effectively mitigating their respective limitations. The primary trial outcomes paper is scheduled to appear in JAMA Pediatrics on September 3, 2024. The research team published the ASPIRE study protocol in Implementation Science:

Beidas, R. S., Ahmedani, B. K., Linn, K. A., Marcus, S. C., Johnson, C., Maye, M., ... & Boggs, J. M. (2021). Study protocol for a type III hybrid effectiveness-implementation trial of strategies to implement firearm safety promotion as a universal suicide prevention strategy in pediatric primary care. Implementation Science, 16, 1-16.