What Are Caring Contacts?

Caring Contacts can be delivered by two-way text message to a large number of participants by a small team. The capacity of a Caring Contacts program is primarily limited by the ratio of follow-up specialist FTE available to support participants. To estimate how many participants your program might serve, you will need to make some assumptions about what proportion of eligible potential participants will enroll in the program. In the SPARC Trial, about 36% of eligible patients screening at risk for suicide were referred to the study by their Primary Care Physician/Provider or ED social worker, and 42% of referred patients went on to enroll in the study. Once these participants graduated from the study, they were offered the opportunity to continue receiving Caring Contacts in a non-research program. About 5% of SPARC participants opted to receive an additional year of Caring Contacts support. Enrollment rates in your organization may differ based on referring staff awareness and attitudes about the program, potential participants’ interest, and ease of enrollment workflows.

Implementation Costs

Program costs will primarily consist of cost of the intervention medium and personnel costs. Depending on which path you take, we expect you might encounter some of the following expenses.

Personnel Costs

Maintaining an appropriate ratio of interventionists to participants is key to ensuring personalized outreach and consistent message delivery in a Caring Contacts program. Previous work in the SPARC and SPRING trials have demonstrated that ~2.5 full time equivalent (FTE) for program staff/follow-up specialists are recommended for the first 1,500 enrolled participants. This ratio allows for appropriate coverage for all operating hours, flexibility in scheduling for anticipated or unexpected life events, and the ability to perform necessary daily work and quality control checks. Once this 1,500-participant threshold is met, an additional ~0.5 FTE for every additional 750 participants is recommended to maintain high quality care in the program.

For budgeting, teams should calculate the number of FTEs needed for the program and multiply by the cost per FTE.Who will send the messages and monitor for responses? Hint: We’ve found that it’s best for authors to have met the patient and established rapport and not be the one providing ongoing care.

Administrative Costs

If you choose to send messages via postal mail, your expenses might include office supplies such as paper, ink, envelopes, or stamps.

If you choose to send messages electronically, an organizational email account or cell phones will be required. Digital options such as Text message will incur per-message fees (often ten cents.)

If you choose to utilize the platform that we recommend in our Practical Guide, Mosio, it provides organizations with the flexibility to utilize a texting platform that can be custom built to best suit the needs of the organization. Our team worked with Mosio to develop a customizable templated build for two-way Caring Contacts. Assisted Setup of Customizable Build and Team Training $2,997*: Allows organizations to customize and use a templated two-way Caring Contacts standard build that our team developed with Mosio. This includes texting number registration, account configuration and customization, and virtual training sessions to introduce the dashboard and provide a detailed walkthrough for the functionalities included plus two-way texting & click-to-call services, and ongoing customer support for the duration of the project. This includes the first-year licensing fee of $XXX, which Mosio charges annually thereafter. Additional Programming Requests: Programing costs for add-ons to the standard Mosio dashboard may be extra. Contact Mosio directly for estimated cost for specific add-on requests that fall outside the scope of the standard setup. Fees may vary depending on program complexity.

(Costs above were quoted for the Caring Contacts Mosio build developed by St. Luke’s and University of Washington in June 2025.)

How much staff time required is highly dependent on group size and your chosen delivery method.

Caring Contacts is a scalable intervention. A low staff volume (1-2) can handle several hundred participants simultaneously. A staff of 2.5 can handle approximately 1,500 participants simultaneously, with an additional 750 participants per extra staff person added.

This is possible as numerous prior studies have shown only a small percentage of active participants actively engage with staff members at any given time.

Timing of message delivery can be custom tailored to only be sent at specific times of the day or week (i.e. during office hours) and participants can be notified not to expect replies afterhours in order to minimize any afterhours staffing requirements

Digital messages often require less staff involvement, while postcards or letters often involve more staff effort to hand write or print and send each message.

Caring Contacts authors don’t need a clinical degree or experience! In most two-way texting research, Caring Contacts authors were trained non-clinicians.

Clinician oversight (Social Worker, Psychologist, Physician, etc.) should be accessible to Caring Contact staff for any risk escalation that requires acute clinical support

During our previous trials, the majority of participant responses were positive or neutral, with some acknowledging challenges without expressing distress and fewer indicating acute distress. You can learn about what sorts of responses we’ve gotten in previous trials on the Examples page.

Examples

We have developed set of example legal agreements and Memorandum of Understanding (MOU) to be used when partnering with other organizations, which your organization may adapt to fit your unique needs.

Open File