title: Safety, Acceptability, and Use of a Smartphone App, BlueIce, for Young People Who Self-Harm: Protocol for an Open Phase I Trial.
abstract: BACKGROUND
  Up to 18% of adolescents will engage in an act of self-harm before young adulthood, with the majority of acts occurring in private. Mobile apps may offer a way of providing support for young people at times of distress to prevent self-harm.
  
  
  OBJECTIVE
  This is a proof-of-concept study designed to explore the safety, acceptability, feasibility, and usability of a smartphone app, BlueIce, with young people who are self-harming.
  
  
  METHODS
  In this phase I open trial we will evaluate BlueIce, a smartphone app developed and coproduced with young people with lived experience of self-harm. BlueIce includes a mood-monitoring diary, selection of mood-lifting techniques based on cognitive behavior therapy and dialectical behavior therapy, and direct access to emergency telephone numbers. We will recruit young people (n=50) attending specialist child and adolescent mental health services with a current or past history of self-harm to trial BlueIce as an adjunct to their usual care. Questionnaires and interviews will be completed at baseline, postfamiliarization (2 weeks), and at follow-up (12 weeks after baseline) to assess safety, app use, and acceptability. Interviews will be undertaken with clinicians to assess the feasibility of BlueIce within a clinical setting.
  
  
  RESULTS
  Recruitment occurred between May and November 2016. The recruitment target was 50, and by the beginning of November 54 young people had been referred.
  
  
  CONCLUSIONS
  This study is the first to evaluate an app specifically developed with young people for young people (under the age of 18 years) who self-harm. It will determine whether BlueIce is acceptable, how often it is used, and whether it is safe and does not have any unintentional adverse effects. This information will determine whether a feasibility trial to test recruitment, randomization, retention, and appropriate outcome measures should be pursued.
authors.affiliation: Child and Adolescent Mental Health Group, Department for Health, University of Bath, Bath, United Kingdom.
authors.forename: Paul
authors.identifier: http://orcid.org/0000-0001-8046-0784
authors.initials: P
authors.lastname: Stallard
authors.affiliation: Child and Family Mental Health, Temple House, Oxford Health National Health Service Foundation Trust, Keynsham, United Kingdom.
authors.forename: Joanna
authors.identifier: http://orcid.org/0000-0002-6971-1105
authors.initials: J
authors.lastname: Porter
authors.affiliation: Child and Adolescent Mental Health Group, Department for Health, University of Bath, Bath, United Kingdom.
authors.forename: Rebecca
authors.identifier: http://orcid.org/0000-0002-4285-5272
authors.initials: R
authors.lastname: Grist
keywords: BlueIce; CBT; DBT; adolescents; self-harm; smartphone app