Instrumental Support Calls vs. Caring Contacts Texts to Prevent Suicide in Adolescents and Adults: The SPARC Randomized Clinical Trial
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: OBJECTIVE: The authors sought to determine whether augmenting usual suicide care with follow-up in the form of instrumental support calls (ISC) or two-way Caring Contacts texts (CC) works best to reduce suicidal ideation and behavior (SI/SB) in adolescents and adults. METHODS: The Suicide Prevention Among Recipients of Care (SPARC) Trial is a pragmatic comparative effectiveness randomized clinical trial stratified by age, with participants randomized in a 1:1 ratio to ISC or CC. Participants were adolescents (12-17 years, N=723) and adults (18+ years, N=797) who screened at risk for suicide in emergency departments (N=9) and primary care clinics (N=36) between May 2021 and July 2022; primary data collection was completed in August 2023. Outcomes included Columbia-Suicide Severity Rating Scale SI/SB score at 6 months (primary) and 12 months (secondary). RESULTS: Adolescents (N=723; mean age, 14.9 years [SD=1.6]) were mostly female (75%), White (84.1%), and non-Hispanic (84.2%). Adults (N=797; mean age, 38.3 years [SD=15.9]) were mostly female (70%), White (89.1%), and non-Hispanic (90%). At 6 months, outcomes were similar by condition among adolescents, but among adults, SI/SB scores were significantly higher among those receiving CC compared to those receiving ISC (adjusted difference in means [ADM]=0.50, 95% CI=0.12, 0.88). At 12 months, adolescents' SI/SB scores were significantly lower in the CC compared with the ISC condition (ADM=-0.64, 95% CI=-1.11, -0.18), but outcomes were similar by condition among adults. CONCLUSIONS: The best suicide prevention follow-up care may vary by age, with adolescents benefiting most from longer-term connection-focused two-way CC and adults benefiting most from more intensive early instrumental support through ISC.
Source: American Journal of Psychiatry
Authors: Anna K. Radin, Jenny Shaw, Siobhan P. Brown, Hilary Flint, Tara Fouts, Elizabeth McCue, Anton Skeie, Cecelia Peña, Jonathan Youell, Matthew Biss, Hannah Lemon, Daniel Sandoval, Jennifer Hartmann, Anna Ratzliff, Diane M. Powers, Elizabeth Hammar, Amelia Doty-Jones, Jacob Wilson, George Austin, Kwun C.G. Chan, Martina Fruhbauerova, Michelle Ross, Megan Stright, Samuel Pullen, Christopher Edwards, Michael Walton, Katherine Anne Comtois
Institutions: University of Washington, University of Kentucky
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W7224086195