NCT03633825

Brief Online Help-seeking Barrier Reduction Intervention

Randomized Controlled Trial of an Online Machine Learning-Driven Risk Assessment and Intervention Platform for Increasing the Use of Crisis Services

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 39,450 (actual)
• Sponsor: Harvard University · Academic / Other
• Sex: All
• Age: —
• Healthy volunteers: Accepted

Summary

Objective: Mental illness is a leading cause of disease burden; however, many barriers prevent people from seeking mental health services. Technological innovations may improve the ability to reach under-served populations by overcoming many existing barriers. The investigators evaluated a brief, automated risk assessment and intervention platform designed to increase the use of crisis resources provided to individuals who were online and in crisis. Hypothesis: The investigators hypothesized that individuals assigned to the intervention condition would report using crisis resources at higher rates than individuals in the control condition. Method: Participants, users of the digital mental health app Koko, were randomly assigned to treatment or control conditions upon accessing the app and were included in the study after their posts were identified by machine learning classifiers as signaling a current mental health crisis. Participants in the treatment condition received a brief Barrier Reduction Intervention (BRI) designed to increase the use of crisis service referrals provided on the app. Participants were followed-up several hours later to assess the use of crisis services.

Conditions

• Crisis Intervention
• Suicide and Depression

Interventions

Type	Name	Description
BEHAVIORAL	Brief help-seeking barrier reduction intervention	The BRI was designed to overcome common concerns and misconceptions (i.e., barriers) related to using crisis services. It works by first asking the user about what potential barriers may keep them from using the crisis service referrals, and then, based on the user's response, by providing information intended to help the user overcome the potential barrier(s) they selected. By exploring the menu of barriers, users could read brief messages designed to dispel common misconceptions or concerns related to each barrier. For example, a common concern among Koko users was that calls to lifelines invariably result in visits by the police or other emergency services. Users who feared this possibility could tap on the associated button and learn that active rescues such as these are extremely rare, and occur in less than one percent of all cases. Whenever possible, we used language throughout the intervention to help validate the experiences of the users.

Timeline

• Start date: 2017-08-10
• Primary completion: 2017-09-20
• Completion: 2017-09-20
• First posted: 2018-08-16
• Last updated: 2023-04-12
• Results posted: 2019-04-17

Locations

1 site across 1 country: United States