Abstract
BackgroundSuicide amongst Australian Aboriginal and Torres Strait Islander communities occurs at twice the rate of the general population and, with significant barriers to treatment, help-seeking prior to a suicide attempt is low. This trial aims to test the effectiveness of an app (iBobbly) designed with Aboriginal and Torres Strait Islander people for reducing suicidal ideation.Methods/designThis is a two-arm randomised controlled trial that will compare iBobbly to a wait-list control condition. The trial aims to recruit Aboriginal and Torres Strait Islander participants aged 16 years and over to test iBobbly, which is a self-help app delivering content based on acceptance and commitment therapy. The primary outcome for the study is suicidal ideation, and secondary outcomes include depression, hopelessness, distress tolerance, perceived burdensomeness and thwarted belonging, and help-seeking intentions. Data will be collected for both groups at baseline, post-intervention (after 6 weeks of app use), and at 6 months post-baseline (with a final 12-month follow-up for the iBobbly group). Primary analysis will compare changes in suicidal ideation for the intervention condition relative to the wait-list control condition using mixed models. An examination of the cost-effectiveness of the intervention compared to the control condition will be conducted.DiscussionIf effective, iBobbly could overcome many barriers to help-seeking amongst a group of people who are at increased risk of suicide. It may provide a low-cost, accessible intervention that can reach more people. This trial will add to a sparse literature on indigenous suicide prevention and will increase our knowledge about the effectiveness of e-health interventions for suicide prevention.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12614000686606. Registered on 30 June 2014.
Highlights
Suicide amongst Australian Aboriginal and Torres Strait Islander communities occurs at twice the rate of the general population and, with significant barriers to treatment, help-seeking prior to a suicide attempt is low
If effective, iBobbly could overcome many barriers to help-seeking amongst a group of people who are at increased risk of suicide
It may provide a low-cost, accessible intervention that can reach more people. This trial will add to a sparse literature on indigenous suicide prevention and will increase our knowledge about the effectiveness of e-health interventions for suicide prevention
Summary
Intervention research in suicide prevention is rare and in Indigenous communities it is all but non-existent [41, 42]. Efforts to reduce suicide amongst Indigenous Australians have far not achieved their outcomes, so this research is critical if our knowledge of Indigenous suicide prevention is to improve [3, 4]. This project has the potential to reach young Indigenous people at risk of suicide who are unable or unwilling to undergo face-to-face treatment with health professionals. If the effectiveness of iBobbly is established, the intervention will be offered broadly, and its reach and impact measured systematically If effective, it will establish new models for the delivery of suicide prevention in Australia by combining an effective intervention within the safety net of a crisis intervention or general practitioner service.
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