(PS2-C63) A Digital Game Intervention Targeting Suicide Prevention in Adolescents with Lifetime Prescription Opioid Misuse

Suicide is the second leading cause of death in adolescents aged 14-18 years. In this age group substance use, specifically prescription opioids, is a risk factor for suicidal thoughts and behaviors. The role of school-based health centers (SBHCs) holds promise as they offer accessible medical and behavioral health services. However, there is a lack of research on effectiveness of behavioral health services delivered in SBHCs, including those that target suicidal thoughts and behaviors. To fill this gap, we will create supportED, a digital game intervention that focuses on preventing suicide in youth who misuse opioids. We will conduct focus groups to inform the development of the digital intervention and discuss approaches to enhance user experiences, acceptability, and feasibility of the intervention. First, we will conduct six focus groups either in-person or over zoom with a total of 40 participants, including 10 high-school-aged adolescents, 10 college-aged youth [aged 18-22], 10 providers, and approximately 10 interviews with adolescents and young adults [aged 16-22] over the course of six months to inform the content of the videogame intervention. The focus group/interview guide will align with constructs from the intersectional ecology model and will include questions related to potential warning signs of emotional distress, coping strategies, and seeking help to prevent suicidal thoughts and behaviors among youth who misuse opioids. Once a prototype is delivered, we will conduct playtesting focus groups (n=15) and cognitive interviews (n=5) to collect feedback and iteratively improve the intervention. The intervention will be finalized in September 2022. Development focus groups and interviews are underway and will be completed by the end of March. We will then analyze these findings to provide content for the videogame. Playtesting focus groups and cognitive interviews will occur in June to provide feedback to our game development company with the goal of finalizing the prototype by August 1. Findings will focus on content related to potential warning signs, coping strategies, and seeking help to prevent suicidal thoughts and behaviors among youth who misuse opioids. Findings will inform the development of a digital intervention to reduce the risk of suicide among adolescents who misuse opioids. Upon completion of development, the intervention will subsequently be evaluated in a pilot randomized controlled trial to assess the preliminary efficacy of the intervention among 60 youth who misuse opioids and may be at risk of suicide. Preliminary efficacy will explore topics on suicidal thoughts and behaviors, intention to use a safety plan, coping strategies, and associated risk factors (e.g., hopelessness, impulsivity, etc.).