The iBobbly Aboriginal and Torres Strait Islander app project: Study protocol for a randomised controlled trial

Abstract

Background 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. This trial aims to test the effectiveness of an app (iBobbly) designed with Aboriginal and Torres Strait Islander people for reducing suicidal ideation. Methods/design This 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. Discussion 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. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12614000686606 . Registered on 30 June 2014. Electronic supplementary material The online version of this article (10.1186/s13063-019-3262-2) contains supplementary material, which is available to authorized users.

Mobile Health for First Nations Populations: Systematic Review

“…This is an important finding given the documented mental health challenges experienced by First Peoples of Australia, New Zealand, and the United States on account of intergenerational trauma [22]. It demonstrates that scientific research is responding to the mental and emotional challenges faced by First Nations populations [53].…”

“…Importantly, beyond social or entertainment value, mobile devices offer significant potential for access to health support in scenarios where individuals hold concerns about face-to-face interaction. For example, tablets may facilitate help-seeking behavior for young people who experience concerns about social interaction and moral judgement when accessing mental health support [26,37,38,53,54]. This systematic review identified significant First Nations expertise that conceivably augmented favorable user perspectives of the mHealth interventions.…”

“…It is also currently being trialed as a well-being intervention with Aboriginal and Torres Strait Islander people with chronic kidney disease [59]. In addition, while the pilot trial of the iBobbly app did not find clinically significant results for suicide ideation, the significant outcomes for depression and psychological distress have justified further app development and a national randomized controlled trial to continue the important work in this area [53].…”

A Systematic Review of the Antecedents and Prevalence of Suicide, Self-Harm and Suicide Ideation in Australian Aboriginal and Torres Strait Islander Youth

“…It has been shown that psychosocial interventions can help reduce self-harm risk [53], but trials of culturally adapted interventions that specifically target self-harm in Aboriginal and Torres Strait Islander populations are sparse [54]. A trial of a self-help mobile phone application, designed with Aboriginal and Torres Strait Islander people, aimed at reducing suicide ideation is currently ongoing [55]. Given the high proportion of Indigenous people living in regional and remote areas, and the high incidence of youth suicide in such areas, a research agenda aimed at profiling the unique psychological, social and cultural needs of these communities in relation to suicide and self-harm is required.…”

Involvement of Indigenous young people in the design and evaluation of digital mental health interventions: a scoping review protocol

“…dMH services are identified as “mental health, suicide prevention and alcohol and other drugs services delivered via a digital platform”, which include the “provision of information, digital counselling services, treatment services (including assessment, triage and referral services) and peer-to-peer support services” [ 10 ]. Some examples of dMH services for Indigenous people include interventions delivered via smartphone applications [ 48 ], therapist-supported digital interventions on tablet devices [ 49 ], online CBT programs [ 50 ] and gamified CBT interventions [ 51 ]. For the purposes of this review, we will include studies reporting on the design, development or evaluation of mental health interventions, which use a digital platform (e.g.…”