Pilot microrandomized trial of a brief digital intervention for suicidal thoughts.

OBJECTIVE: The goal of this study was to conduct a pilot microrandomized trial to assess the feasibility and acceptability of a brief digital intervention aimed at promoting in-the-moment coping strategy use for suicidal thoughts after psychiatric hospitalization. METHOD: Seventy-one adults hospitalized for suicide risk (Mage = 31.94 years, 46.48% female, 78.87% White) were enrolled and included in analyses. Real-time reports of suicidal thoughts were collected for 28 days after discharge via ecological momentary assessment. Each time participants reported an elevated momentary suicide urge or intent on an ecological momentary assessment survey, they were randomized to smartphone-based messages aimed at promoting the use of evidence-based coping strategies (vs. "no message" control). Messages included either personalized or general coping strategy recommendations. RESULTS: Forty-four participants (57.89%) met criteria for randomization at least once and were randomized on average 11.48 times (SD = 23.38); 8.85% of completed ecological momentary assessments met randomization criteria. Participants found the intervention messages feasible and acceptable. Most described the messages as helpful and preferred personalized (over general) messages. Statistical analyses revealed no group-level iatrogenic intervention effects. Following intervention (vs. no intervention), participants were significantly more likely to report use of a coping strategy to manage suicidal thoughts, with stronger effects for personalized messages. CONCLUSIONS: This pilot microrandomized trial supports the feasibility and acceptability of a brief digital intervention for promoting in-the-moment coping strategy use during episodes of suicidal thinking. Results inform the development of novel just-in-time adaptive interventions for suicide prevention and the design of larger-scale microrandomized trials to evaluate and optimize them. (PsycInfo Database Record (c) 2025 APA, all rights reserved).