5 - (SYM 114) Clinician Perceptions of Two Approaches to the Safety Planning Intervention Tailored for Autistic Individuals

Background: Suicide risk is heightened among autistic individuals, yet interventions tailored for this high-risk population are lacking. Authentic engagement of individuals with lived experience and other community partners is critical to address this gap. Key steps include adapting evidence-based treatments, such as the Safety Planning Intervention (SPI), to better fit the needs and learning styles of autistic individuals and optimizing implementation to maximize impact and reach.

Evidence supporting SPI is typically drawn from trials with SPI followed by two or more structured contacts. Structured follow up is rarely implemented in clinical practice, yet little is known about the comparative impact of SPI with and without follow up, particularly in autistic individuals. We partnered with autistic individuals, family members, and clinicians to adapt SPI with and without follow up (SPI-A and SPI-A+, respectively) and to compare the impact of these approaches on clinical and implementation outcomes in an ongoing multisite trial. This presentation will focus on: (1) our community-partnered approach to SPI-A and SPI-A+ adaptation, guided by the ADAPT-ITT framework, and (2) clinician-level factors that commonly influence implementation, including attitudes, self-efficacy, acceptability, and feasibility in SPI-A or SPI-A+ trained clinicians.

Method: Clinicians from four health systems were randomized to SPI-A (n = 103) or SPI-A+ (n = 101) training. We compared attitude and self-efficacy ratings pre- and post-training and across conditions. We also compared post-training ratings of the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM) across conditions, with item scores ranging from 1-5 (5 = most acceptable, appropriate, and feasible).

Results: Clinicians’ average age was 36.66 (SD = 10.26). Most identified as female (87%) and white (73%). Attitudes and self-efficacy improved from pre- to post-training across conditions (t(203) = 6.76, p < .001; t(203) = 7.33, p < .001). Average FIM (M = 4.21, SD = .62), IAM (M=4.24, SD=.63), and AIM (M = 4.15, SD = .59) item scores were similarly high across conditions.

Conclusion: Both training programs were associated with improved attitudes and self-efficacy. Despite the added follow-up component, SPI-A+ was perceived as equally feasible, appropriate, and feasible as SPI-A. Results show promise for the scalability of tailored suicide prevention care for autistic individuals.