Falling between the cracks: The effect of using different levels of suicide risk exclusion criteria on sample characteristics when recruiting for an online intervention for depression

TY - JOUR

T1 - Falling between the cracks

T2 - The effect of using different levels of suicide risk exclusion criteria on sample characteristics when recruiting for an online intervention for depression

AU - Godinho, Alexandra

AU - Schell, Christina

AU - Cunningham, John A.

N1 - Funding Information: This research is funded by the Canadian Institutes of Health Research grant number PJT 153 324; however, the findings and conclusions of this paper are solely of the authors and do not necessarily represent the views of the Canadian Institutes of Health Research. The funding body has no role or influence on the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. Support to CAMH for salary and infrastructure has been provided by the Ministry of Health and Long-Term Care. Funding Information: This research is funded by the Canadian Institutes of Health Research grant number PJT 153 324; however, the findings and conclusions of this paper are solely of the authors and do not necessarily represent the views of the Canadian Institutes of Health Research. The funding body has no role or influence on the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. Publisher Copyright: © 2021 The Authors. Suicide and Life-Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/5/7

Y1 - 2021/5/7

N2 - Background: Despite a strong link between suicide risk and depression, a recent literature review found that many effectiveness studies for online depression interventions exclude individuals at risk of suicide. This study scrutinizes how different suicide risk exclusion criteria impact recruitment rates and final sample characteristics. Materials and Methods: Two recruitment periods for an online depression intervention trial utilized different suicide risk cutoff exclusion criteria, a one-point difference on the last item of the Personal Health Questionnaire (i.e., more than 0 (Not at all) vs. more than 1 (Several Days)). Bivariate statistics were used to assess differences in recruitment rates and sample characteristics between these two recruitment periods, while all other eligibility criteria and recruitment strategies remained consistent. Results: The recruitment period using the least restrictive suicide risk exclusion criteria yielded twice as many participants; however, recruited sample characteristics did not significantly differ among demographic or clinical characteristics, despite observable trends. Discussion: Researchers should carefully select suicide risk exclusion criteria that balance recruitment rates, study budgets, and sample selection biases, while minimizing participant harm. Moreover, researchers are urged to report suicide risk exclusion rates and consider these exclusions when interpreting results. Limitations of the results are also discussed.

AB - Background: Despite a strong link between suicide risk and depression, a recent literature review found that many effectiveness studies for online depression interventions exclude individuals at risk of suicide. This study scrutinizes how different suicide risk exclusion criteria impact recruitment rates and final sample characteristics. Materials and Methods: Two recruitment periods for an online depression intervention trial utilized different suicide risk cutoff exclusion criteria, a one-point difference on the last item of the Personal Health Questionnaire (i.e., more than 0 (Not at all) vs. more than 1 (Several Days)). Bivariate statistics were used to assess differences in recruitment rates and sample characteristics between these two recruitment periods, while all other eligibility criteria and recruitment strategies remained consistent. Results: The recruitment period using the least restrictive suicide risk exclusion criteria yielded twice as many participants; however, recruited sample characteristics did not significantly differ among demographic or clinical characteristics, despite observable trends. Discussion: Researchers should carefully select suicide risk exclusion criteria that balance recruitment rates, study budgets, and sample selection biases, while minimizing participant harm. Moreover, researchers are urged to report suicide risk exclusion rates and consider these exclusions when interpreting results. Limitations of the results are also discussed.

UR - https://www.scopus.com/pages/publications/85105194493

U2 - 10.1111/sltb.12761

DO - 10.1111/sltb.12761

M3 - Article

AN - SCOPUS:85105194493

SN - 0363-0234

VL - 51

SP - 736

EP - 740

JO - Suicide and Life-Threatening Behavior

JF - Suicide and Life-Threatening Behavior

IS - 4

ER -