TIPS (Trans-Tasman Internet-delivered Prevention of (youth) Suicide) study: protocol for a randomised controlled trial of mobile health interventions (four apps) to help young people reduce suicidal ideation

BMJ Open. 2026 Apr 28;16(4):e114884. doi: 10.1136/bmjopen-2025-114884.

ABSTRACT

INTRODUCTION: Suicidal ideation is common in young people and increases the risk of suicide. Effective interventions that are relevant and accessible to young people, so-called digital natives, are urgently required. There are key questions regarding the cross-cultural efficacy of suicide prevention applications (apps) for scalability.

METHODS AND ANALYSIS: This online four-arm parallel randomised controlled superiority trial will enrol 1480 young people aged 16-24 years with current suicidal ideation in New Zealand and Australia. Participants will be randomised to one of three therapeutic apps developed in different countries, Tune In, Bro and LifeBuoy, or to My Mood (attention control). The primary outcome is suicidal ideation severity at 30-day and 90-day post-baseline; secondary outcomes include mental well-being, engagement and acceptability. Emotional regulation will be examined as a mediator of change in suicidal ideation. All outcomes are measured by self-reported scales incorporated in an online questionnaire. Acceptability of the apps for rangatahi Māori (Indigenous youth, New Zealand) will be explored via semi-structured interviews. Linear mixed models with repeated measures analyses, using maximum likelihood estimation, an appropriate covariance structure and consideration of site effects, will be undertaken. Examination of an individual app intervention effects in New Zealand and Australia will highlight the effects of apps developed for a different country.

ETHICS AND DISSEMINATION: Approval was obtained (26 February 2025) from the Health and Disability Ethics Committees (Ministry of Health ref 2025 EXP 21500). Participants provide informed consent online. Trial results will be submitted for publication in peer-reviewed journals, shared on relevant websites and via presentation at international scientific conferences; Individial Patient Data will only be shared if requested and subsequent to review.

TRIAL REGISTRATION NUMBER: ACTRN12625000349448.

PMID:42049311 | DOI:10.1136/bmjopen-2025-114884