PMID- 31939744 OWN - NLM STAT- MEDLINE DCOM- 20210401 LR - 20240328 IS - 2291-5222 (Electronic) IS - 2291-5222 (Linking) VI - 8 IP - 1 DP - 2020 Jan 15 TI - Mobile Health Technology Interventions for Suicide Prevention: Systematic Review. PG - e12516 LID - 10.2196/12516 [doi] LID - e12516 AB - BACKGROUND: Digital interventions are proposed as one way by which effective treatments for self-harm and suicidal ideation may be improved and their scalability enhanced. Mobile devices offer a potentially powerful medium to deliver evidence-based interventions with greater specificity to the individual when the intervention is needed. The recent proliferation of publicly available mobile apps designed for suicide prevention underlines the need for robust evidence to promote safe practice. OBJECTIVE: This review aimed to examine the effectiveness of currently available mobile health (mHealth) technology tools in reducing suicide-specific outcomes. METHODS: The following databases were searched: Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE, EMBASE, PsycINFO, and relevant sources of gray literature. All published and unpublished randomized controlled trials (RCTs), pseudo-RCTs, and pre-post observational studies that evaluated the effectiveness of mHealth technology in suicide prevention delivered via mobile computing and communication technology were included. Studies were included if they measured at least one suicide outcome variable (ie, suicidal ideation, suicidal intent, nonsuicidal self-injurious behavior, and suicidal behavior). A total of 2 review authors independently extracted data and assessed study suitability, in accordance with the Cochrane Collaboration Risk of Bias Tool, on July 31, 2018. Owing to the heterogeneity of outcomes found across studies, results were not amenable for pooled synthesis, and a meta-analysis was not performed. A narrative synthesis of the available research is presented here. RESULTS: A total of 7 studies met criteria for inclusion . Four published articles that reported on the effectiveness of the following mobile phone apps were included: iBobbly, Virtual Hope Box, BlueIce, and Therapeutic Evaluative Conditioning. Results demonstrated some positive impacts for individuals at elevated risk of suicide or self-harm, including reductions in depression, psychological distress, and self-harm and increases in coping self-efficacy. None of the apps evaluated demonstrated the ability to significantly decrease suicidal ideation compared with a control condition. In addition, 3 unpublished and recently completed trials also met criteria for inclusion in the review. CONCLUSIONS: Further research is needed to evaluate the efficacy of stand-alone mHealth technology-based interventions in suicide prevention. The small number of studies reported in this review tentatively indicate that such tools may have a positive impact on suicide-specific outcomes. Future mHealth intervention evaluations would benefit from addressing the following 3 main methodological limitations : (1) heterogeneity of outcomes: a lack of standardized measurement of suicide outcomes across studies; (2) ecological validity: the tendency to exclude potential participants because of the elevated suicide risk may reduce generalizability within clinical settings; and (3) app regulation and definition: the lack of a standardized classification system for mHealth intervention type points to the need for better definition of the scope of such technologies to promote safe practice. TRIAL REGISTRATION: PROSPERO CRD42017072899; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=72899. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/resprot.8635. CI - (c)Ruth Melia, Kady Francis, Emma Hickey, John Bogue, Jim Duggan, Mary O'Sullivan, Karen Young. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 15.01.2020. FAU - Melia, Ruth AU - Melia R AUID- ORCID: 0000-0002-1152-5510 AD - School of Psychology, National University of Ireland Galway, Galway, Ireland. AD - Psychology Department, Health Service Executive Mid-West, Ennis, Ireland. FAU - Francis, Kady AU - Francis K AUID- ORCID: 0000-0001-8161-4546 AD - School of Psychology, National University of Ireland Galway, Galway, Ireland. FAU - Hickey, Emma AU - Hickey E AUID- ORCID: 0000-0003-4576-9828 AD - Psychology Department, Health Service Executive Mid-West, Limerick, Ireland. FAU - Bogue, John AU - Bogue J AUID- ORCID: 0000-0002-7070-1561 AD - School of Psychology, National University of Ireland Galway, Galway, Ireland. FAU - Duggan, Jim AU - Duggan J AUID- ORCID: 0000-0002-7507-8617 AD - Discipline of Information Technology, National University of Ireland Galway, Galway, Ireland. FAU - O'Sullivan, Mary AU - O'Sullivan M AUID- ORCID: 0000-0003-0832-6921 AD - School of Psychology, National University of Ireland Galway, Galway, Ireland. FAU - Young, Karen AU - Young K AUID- ORCID: 0000-0002-9452-2293 AD - Insight-Centre, Discipline of Information Technology, National University of Ireland Galway, Galway, Ireland. LA - eng PT - Journal Article PT - Systematic Review DEP - 20200115 PL - Canada TA - JMIR Mhealth Uhealth JT - JMIR mHealth and uHealth JID - 101624439 SB - IM MH - Biomedical Technology MH - Humans MH - *Mobile Applications MH - Technology MH - *Telemedicine MH - *Suicide Prevention PMC - PMC6996750 OTO - NOTNLM OT - mHealth OT - systematic review COIS- Conflicts of Interest: None declared. EDAT- 2020/01/16 06:00 MHDA- 2021/04/02 06:00 PMCR- 2020/01/15 CRDT- 2020/01/16 06:00 PHST- 2018/10/16 00:00 [received] PHST- 2019/08/02 00:00 [accepted] PHST- 2019/05/17 00:00 [revised] PHST- 2020/01/16 06:00 [entrez] PHST- 2020/01/16 06:00 [pubmed] PHST- 2021/04/02 06:00 [medline] PHST- 2020/01/15 00:00 [pmc-release] AID - v8i1e12516 [pii] AID - 10.2196/12516 [doi] PST - epublish SO - JMIR Mhealth Uhealth. 2020 Jan 15;8(1):e12516. doi: 10.2196/12516.