Plan and Protect: Safety Planning for Teens in Rural Emergency Departments

Summary

The goal of this observational study is to determine whether implementing a culturally sensitive, tablet-based safety planning program called Plan \& Protect (P\&P) within rural emergency departments can improve home safety and reduce suicide risk in adolescents presenting with suicidality.

The main questions it aims to answer are:

* Will implementing P\&P increase caregiver-reported home safety (reduce access to firearms and unsafe medication storage) for adolescents 12-17 years old presenting to rural EDs with suicidal ideation, self-harm, or mental health crisis?
* Will implementing P\&P decrease adolescent-reported perceived suicide risk and related outcomes (e.g., suicide events, and attendance at follow-up mental healthcare)?

Researchers will compare outcomes for adolescents and caregivers receiving P\&P (implemented as the new standard of care at sites during the intervention periods) to those receiving usual care (prior to P\&P implementation at those hospitals) to see if P\&P increases home safety and decreases suicide risk and related healthcare utilization.

Participants will, if clinically appropriate:

* Complete the tablet-based P\&P modules during their ED visit
* Complete self-report measures at baseline, \~30 days, and \~3 months post-discharge
* A subset will also participate in semi-structured interviews

Conditions

• Suicide Ideation
• Suicide Attempt

Interventions

BEHAVIORAL

Plan & Protect safety planning intervention

Plan and Protect (P\&P) is a tablet-based, family-centered quality improvement program targeted to rural Northern New England that combines a youth-facing safety-planning module with a caregiver-facing home safety decision aid and youth safety information. The goal is to help adolescents and their caregivers develop concrete, culturally-sensitive safety plans during emergency department visits.

BEHAVIORAL

Care as usual

Adolescents and caregivers will receive treatment as usual at the Emergency Department.

Sponsors & Collaborators

• National Institute of Nursing Research (NINR)

  collaborator NIH

• Trustees of Dartmouth College

  collaborator OTHER

• Dartmouth-Hitchcock Medical Center

  lead OTHER

Principal Investigators

• JoAnna K Leyenaar, MD, PhD, MPH · Dartmouth College

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

12 Years

Max Age

17 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-06-01

Primary Completion

2028-09-30

Completion

2028-09-30

Countries

• United States

Study Locations