JASPR (SIGNATURE PROJECT): ABSTRACT Significance: The significance of this Signature Project is derived from its powerful combination of (1) targeting a high-risk population -- adult patients at risk for suicide presenting to emergency departments (EDs); (2) addressing trenchant barriers that have prevented delivery of suicide-related evidence-based practices (EBPs) in the ED through an innovative, multi-component, NIMH-funded technology called Jaspr; and (3) evaluating Jaspr’s efficacy, effectiveness, and implementation, all in the same highly efficient study. Investigators: Jaspr’s project team has pioneered ED systems-based suicide prevention using continuous quality improvement implementation strategies (Boudreaux, Kiefe, Larkin, Johnson, Volturo); digital behavioral health technology development and deployment (Boudreaux, Dimeff, Gerber); using multi-method approaches, including patient-reported measures, electronic health record (EHR) data, and death registries, for outcome and intervention target ascertainment (Boudreaux, Kiefe, Gerber); implementation science research design and analytic methodologies (Kiefe, Yang, Larkin); and healthcare economics (Singh, Clements). Innovation: This will be the first study to comprehensively evaluate a multi-component suicide prevention technology that facilitates delivery of suicided-related EBPs while replacing wasted waiting time with productive time. Its multi-component nature satisfies several key performance elements for systems adopting Zero Suicide. A novel, award-winning hybrid study design called Complementary Randomized Controlled Trial and Real-World Study for Efficacy, Effectiveness, and Implementation Design (CREID) will be used. Approach: CREID comprises two separate but related components or parts. Part A, Randomized Controlled Trial (RCT), will be a patient-level, randomized, parallel-arm, single-blind trial (n=670) comparing Jaspr (Intervention) to enhanced treatment as usual (ETAU; Active Comparator Control). Consistent with NIMH’s experimental therapeutics paradigm, Part A’s primary aim is to determine Jaspr’s efficacy in improving suicide- related outcomes in the 12 months after the index ED visit and to explore its potential mechanisms of action through engaging patient intervention targets and EBP delivery. In Part B, Real-World Study, four diverse EDs will implement Jaspr as part of routine care. Part B’s primary aim will be to evaluate Jaspr’s effectiveness when used in a real-world setting. Finally, both Parts will be used to explore Jaspr’s implementation, including establishing system, clinician, and patient factors anticipated to affect Jaspr adoption and implementation. Environment: The UMass Chan Medical School (UMass), Jaspr Health, and partnering organizations have proven their ability to support this ambitious study by their success with numerous NIMH-funded, systems-based suicide prevention studies and SBIR/STTRs technology grants, including the SBIR that created Jaspr. Impact: Accelerated translation of Jaspr and advancing knowledge pertaining to the implementation of suicide care technologies in the ED setting has the potential to help thousands of suicidal individuals annually.

JASPR (SIGNATURE PROJECT): NARRATIVE See Project Narrative in the Overall component.