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Efficacy of the I-CARE Digital Health Intervention

Sponsor: Dartmouth-Hitchcock Medical Center • ClinicalTrials.gov ID: NCT07150832

Registry updated: 2026-10-01

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Description

When presenting to an ED with suicide, self-harm or other mental health crises, youth may also experience "boarding", which is defined by the Joint Commission as "the practice of holding patients in the ED or another temporary location after the decision to admit or transfer has been made." A recent national survey of 88 US acute care hospitals conducted by our research team found that 98.9% of hospitals were boarding youth awaiting psychiatric hospitalization, for an average of 2-3 days. However, as illustrated in a systemic review, little research has focused on developing interventions to support youth during this highly vulnerable time. 3 I-CARE is a modular, blended digital health intervention facilitated by individuals who are not mental health clinical staff to teach youth evidence-based psychosocial skills during the boarding period. This study will evaluate I-CARE's efficacy using a patient-level randomized clinical trial (RCT), randomizing youth to receive standard safety supervision or I-CARE in addition to standard safety supervision. If found to the efficacious, I-CARE could be scaled-up in new settings with limited resources and has the potential to significantly improve the quality of care received by youth experiencing boarding.

Interventions

Improving Care, Accelerating Recovery & Education (ICARE) (Behavioral)
I-CARE is a brief, digital intervention designed for adolescents who are boarding in a medical hospital awaiting transfer to a psychiatric inpatient unit. It consists of 7 tablet-based animated video modules and workbook exercises, facilitated by individuals who are not mental health professionals. All modules are grounded in evidence-based practices, such as cognitive-behavioral therapy and dialectical behavior therapy.

Eligibility criteria

Inclusion Criteria: * Adolescents of any sex and gender, aged 12-17 years at ED visit or hospital encounter * Presenting with suicide attempt or ideation, or self-harm * Medically stable * English-speaking * Awaiting transfer for inpatient psychiatric care or disposition. Exclusion Criteria: * Cognitive or developmental delays precluding participation (intellectual functioning \<12 years of age) * Behavioral limitations that preclude program participation * Active psychosis * Legal parent/caregiver unable to speak English or unavailable to provide consent (e.g. Wards of the State)

Conditions

Mental Health Disorder Suicide Attempt Suicidal Ideation Emergency Psychiatric

Locations

Yale — New Haven, Connecticut, United States
Dartmouth College — Hanover, New Hampshire, United States
Dartmouth Health — Lebanon, New Hampshire, United States
Weill Cornell Medicine — New York, New York, United States

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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