Evidence map›Paper›PMID 40598126›Full record

ArticleBMC psychiatry2025

Safety planning and transdiagnostic cognitive behavioral therapy for adolescent suicide prevention in Mozambique: study protocol for the SPI/TCBT-S hybrid effectiveness/implementation cluster randomized trial.

Bradley H Wagenaar, Alberto Muanido, Morgan Turner, Kathryn L Lovero, Doyanne Darnell, Monisha Sharma, Katherine Anne Comtois, Isaías Ramiro, Vasco F J Cumbe

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06465381 (Safety Planning and Cognitive Behavioral Therapy for Adolescent Suicide Prevention in Mozambique), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06465381 narecruitingnot on this map

Safety Planning and Cognitive Behavioral Therapy for Adolescent Suicide Prevention in Mozambique: A Hybrid Effectiveness/Implementation Cluster Randomized Trial

TypeinterventionalSponsorUniversity of WashingtonRan2025 to 2028Enrolled2,100ConditionsSuicide PreventionArmsSafety Planning Intervention, Enhanced Usual Care, Transdiagnostic Cognitive Behavioral Therapy for Suicide Prevention
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Bradley H WagenaarDepartment of Global Health, University of Washington, 3980 15Th Ave NE, Seattle, WA, 98105, USA. wagenaarb@gmail.com.
Alberto MuanidoMozambique Health Committee, Beira, Mozambique.
Morgan TurnerDepartment of Global Health, University of Washington, 3980 15Th Ave NE, Seattle, WA, 98105, USA.
Kathryn L LoveroDepartment of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
Doyanne DarnellDepartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
Monisha SharmaDepartment of Global Health, University of Washington, 3980 15Th Ave NE, Seattle, WA, 98105, USA.
Katherine Anne ComtoisDepartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
Isaías RamiroMozambique Health Committee, Maputo, Mozambique.
Vasco F J CumbeProvincial Health Directorate, Sofala Province, Ministry of Health, Beira, Mozambique.

Funding

Safety Planning and Cognitive Behavioral Therapy for Adolescent Suicide Prevention in Mozambique: A Hybrid Effectiveness/Implementation Cluster Randomized TrialR01MH134882 · NIMH · UNIVERSITY OF WASHINGTON · PI Bradley Wagenaar · 2024 to 2026
$1.9M
NIMH NIH HHS R01 MH134882NIMH NIH HHS R01MH134882
6 · The paper itself

Abstract

backgroundMore than 75% of suicide deaths occur in low-and middle-income countries (LMICs) and almost 90% of adolescents who die by suicide live in LMICs. Globally, suicide is the fourth leading cause of death for youth aged 15-29. Six of the top 10 countries by suicide rates in the world are in the African region. Despite this, there are few to no evidence-based youth suicide prevention packages developed for, and tested in, the African context. To address this gap, this study aims to test effectiveness and implementation outcomes for the brief Safety Planning Intervention (SPI) and the more resource-intensive multi-session Transdiagnostic Cognitive Behavioral Therapy Intervention for Suicide Prevention (TCBT-S) delivered by non-specialists in Mozambican secondary schools.

methodsUsing a three-arm, parallel, Hybrid Type-1 cluster randomized trial design, we will randomize 7 secondary schools each to Enhanced Usual Care (EUC), SPI alone, and TBCT-S (21 schools total) to evaluate effects on suicidal behaviors (primary) and suicidal ideation/depressive symptoms (secondary). Exploratory structural equation modeling will examine potential mechanisms of intervention effects. Implementation outcomes, barriers, and facilitators to EUC, SPI, and TCBT-S implementation will be assessed using the RE-AIM evaluation and CFIR determinant frameworks. Costs and cost-effectiveness will be evaluated using a Markov model parameterized with cost and trial outcomes data and be applied to projecting budget impact and potential scale-up to provincial and national levels. DISCUSSION: This study is innovative in being the first, to our knowledge, to rigorously test SPI and TCBT-S for adolescent suicide prevention in Sub-Saharan Africa. By simultaneously testing the brief SPI alone - as well as integrated into a more resource-intensive TCBT-S - this study will examine whether the potential gains in effectiveness with the more resource intensive TCBT-S justify its scale-up versus the brief SPI intervention. If effective, SPI or TCBT-S have a large potential to be rapidly scaled up to safeguard youth mental health in Mozambique and other similar LMICs.

trial registrationClinicalTrials.gov; NCT06465381; https://clinicaltrials.gov/study/NCT06465381 .

Indexed as

Cognitive Behavioral TherapySuicide PreventionAdolescentAdolescent BehaviorDepressionFemaleHumansMaleMozambiqueRandomized Controlled Trials as TopicSuicidal IdeationAdolescent healthCluster randomized trialCognitive behavioral therapyHybrid effectiveness/implementation trialMozambiqueSafety planningSuicide prevention

Identifiers

PMID40598126
PMCPMC12219529

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.