Frequency and predictors of virtual hope box use in individuals experiencing suicidal ideation: An ecological momentary assessment investigation

Introduction
The Virtual Hope Box (VHB) is a smartphone application designed to support emotion regulation when one is distressed, in a crisis, or experiencing suicidal ideation (SI). Initial proof of concept studies indicate that individuals are more likely to use the VHB than traditional hope boxes, and find it both easy to setup and helpful. To our knowledge, no studies have harnessed ambulatory assessment methodology to assess VHB use as it relates to incidence of suicidal thinking.
Methods
As such, we recruited N = 50 undergraduates who endorsed SI either the past year or past 2 weeks to complete a 10-day investigation. At baseline, participants were oriented to the VHB and instructed on how to use the application. Over the next 10 days, participants responded to prompts five times per day on their personal smartphones regarding their current experiences of SI and stress as well as VHB usage.
Results
Results found that most participants used the VHB at least once, rated its usefulness as high, and rated their perceived likelihood of future use as high. In addition, increases in state SI severity were related to subsequent VHB use.
Conclusion
The VHB may be a useful tool for managing crises in undergraduates experiencing suicidal thoughts.