integrated Care to Help At-Risk Teens (iCHART)
Project Description
The iCHART (integrated Care to Help At-Risk Teens) intervention is a randomized control trial involving 900 adolescents (ages 12-18) who are randomly assigned to either the iCHART group or Treatment as Usual (TAU) group. The iCHART intervention is a digital program designed to help reduce depressive symptoms and suicidality in adolescents and support pediatric providers in identifying and managing teens at risk for depression and/or suicidality. It integrates several digital tools to enhance screening, treatment engagement, and safety planning.
Project Background
The iCHART intervention was developed by the University of Pittsburgh in collaboration with UPMC and is part of the broader ETUDES Center, a National Institute of Mental Health-funded initiative aimed at improving suicide prevention and mental health care for adolescents in pediatric primary care settings. Suicide is among the leading causes of death for adolescents and young adults, so this study aims to determine if iCHART can reduce suicide-related events by 50% compared to the TAU group. Researchers are also examining factors such as treatment engagement and the effectiveness of safety planning.
Clinical Trials.gov number
NCT05748730
FAQs
What makes up iCHART?
iCHART includes 3 components delivered through your phone:
The BRITE app (which stands for "Brightening the Future of Individuals at Risk for Suicide Through Technology-Enhanced Safety Planning") is a smartphone application designed to help adolescents manage suicidal thoughts and behaviors through personalized coping strategies, daily distress monitoring, and skill practice reminders.
Text2Connect (T2C) is an automated text messaging tool to promote engagement with BRITE when adolescents are distressed or disengaged. Text2Connect reminds teens that they have the BRITE app after 3 days of non-use and suggests coping skills for adolescents to try in times of high disress.
The Enhanced Mental Health Screener is completed separately by both parent and teen and screens for additional comorbidities in the adolescent (i.e., anxiety, mania, substance use), inquiring about treatment preferences, and identifying barriers to treatment. The findings from the EMH Screener compile parent and teen perspectives, providing their PCP with useful information for more personalized referrals and assisting families in planning their next steps in care.
Who is the BRITE app for?
BRITE is intended for adolescents (ages 12-18) who are at risk of suicide and who have been randomized, like a flip of a coin, into the iCHART intervention.
How does the BRITE app work?
The BRITE app helps adolescents build self-awareness around distress with daily mood check-ins. Our clinical assessors collaborate with teens on a personalized coping plan and strategies that are embedded in the BRITE app to manage suicidal thoughts. The app includes features intended to encourage daily engagement and will notify participants via Text2Connect to reach out to social supports or crisis hotlines when necessary.
What information is shared?
One of our aims is to promote treatment engagement between families and providers. After iCHART onboarding, the Enhanced Mental Health screener results and the participant’s safety plan will be shared with their pediatrician. We may also share safety information with the teen’s therapist or psychiatrist, when applicable, but only with Release of Information permission from the parent.
How long will the participant have the app?
We intend every participant to use the app daily for the duration of main study participation (12 months). The participant will not be asked to remove the app after study completion, and they can keep the app on their phone.
