Opportunities for suicide prevention integration into task-shifted mental health interventions in low-resourced contexts

在资源匮乏的情况下将自杀预防纳入任务转移的心理健康干预措施的机会

• 批准号: 10301526
• 负责人: Ashley K Hagaman
• 金额: $ 17.94万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-19 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10301526
• 关键词: Advisory Committees; Advocacy; Age; Asia; Award; Birth; Cause of Death; Cessation of life; Child; Child Rearing; Chronic; Clinical Trials; Communities; Community Integration; Competence; Consolidated Framework for Implementation Research; Data; Detection; Disadvantaged; Early identification; Educational workshop; Enrollment; Epidemiology; Ethics; Ethnography; Event; Evidence based practice; Family dynamics; Feeling suicidal; Funding; Future; Goals; Grant; Health; Healthcare; High Prevalence; Individual; Infrastructure; Intervention; Longitudinal cohort; Maternal Health; Maternal Mortality; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methods; Modeling; Monitor; Mothers; National Institute of Mental Health; Outcome; Pakistan; Pattern; Population; Pregnant Women; Prevention; Prevention Research; Prevention strategy; Prevention trial; Procedures; Protocols documentation; Psyche structure; Public Health; Recurrence; Research; Research Design; Research Personnel; Research Project Grants; Resources; Risk Factors; Role; Rural; Safety; Savings; South Asian; Stress; Structure; Suicide; Suicide prevention; System; Testing; Thinking; Time; Training; United States National Institutes of Health; Violence; Woman; Work; Workload; acceptability and feasibility; base; career; clinical care; collaborative care; data sharing; design; evidence base; experience; implementation outcomes; implementation science; implementation strategy; improved; instrument; longitudinal analysis; low and middle-income countries; maternal depression; member; mental health education; mortality; motherhood; peer; perinatal period; pilot trial; population health; pregnant; preventive intervention; programs; protective factors; public health relevance; reproductive; response; screening; skills; suicidal behavior; suicidal risk; suicide rate; symposium; volunteer; Advisory Committees; Advocacy; Age; Asia; Award; Birth; Cause of Death; Cessation of life; Child; Child Rearing; Chronic; Clinical Trials; Communities; Community Integration; Competence; Consolidated Framework for Implementation Research; Data; Detection; Disadvantaged; Early identification; Educational workshop; Enrollment; Epidemiology; Ethics; Ethnography; Event; Evidence based practice; Family dynamics; Feeling suicidal; Funding; Future; Goals; Grant; Health; Healthcare; High Prevalence; Individual; Infrastructure; Intervention; Longitudinal cohort; Maternal Health; Maternal Mortality; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methods; Modeling; Monitor; Mothers; National Institute of Mental Health; Outcome; Pakistan; Pattern; Population; Pregnant Women; Prevention; Prevention Research; Prevention strategy; Prevention trial; Procedures; Protocols documentation; Psyche structure; Public Health; Recurrence; Research; Research Design; Research Personnel; Research Project Grants; Resources; Risk Factors; Role; Rural; Safety; Savings; South Asian; Stress; Structure; Suicide; Suicide prevention; System; Testing; Thinking; Time; Training; United States National Institutes of Health; Violence; Woman; Work; Workload; acceptability and feasibility; base; career; clinical care; collaborative care; data sharing; design; evidence base; experience; implementation outcomes; implementation science; implementation strategy; improved; instrument; longitudinal analysis; low and middle-income countries; maternal depression; member; mental health education; mortality; motherhood; peer; perinatal period; pilot trial; population health; pregnant; preventive intervention; programs; protective factors; public health relevance; reproductive; response; screening; skills; suicidal behavior; suicidal risk; suicide rate; symposium; volunteer

ABSTRACT Suicide is a leading contributor to global mortality and rates have remained steady, or increased, in low- resourced settings. Motherhood is both a protective and risk factor for suicidal thoughts and behaviors. In the perinatal period, women have increased risk for suicidal ideation and experience higher rates of violence and violent death. Given rising suicide rates, the importance of the perinatal period for both mother and child, and growing dissemination of task-shifting programs to treat common mental disorders, there is critical and urgent need to incorporate implementation strategies for suicide detection and referral within these programs. While task-shifted mental health interventions have trained peer community members to successfully deliver low intensity interventions where access to clinical care is limited, peers remain an untapped resource to provide suicide prevention support in settings where it is needed most. The goal of this award is to broaden the candidate’s expertise to conduct independent clinical trials related to suicide prevention research focused on the integration of community-delivered detection and response in low-resourced, high need, settings. Through structured mentorship from an expert team, coursework, workshop, and conference attendance, the candidate will develop new competencies in suicide prevention research, including: (1) quantitative training in longitudinal analysis for rare events (2) implementation science methods and research design to apply to suicide prevention interventions; and (3) clinical trial management skills, including ethical conduct of suicide prevention research in resource strained contexts, to become a NIH-funded independent investigator. Drs. Donna Spiegelman, Joanna Maselko, Atif Rahman, Paul Pfeiffer, and Byron Powell (alongside a Pakistani advisory committee) will mentor and advise the candidate to meet these objectives. The proposed research will (1) examine the epidemiology and health impacts of recurrent suicidal ideation on mothers over time, (2) characterize key features of suicidal ideation and finalize intervention package components for the study context, and (3) conduct a pilot clinical trial to assess the feasibility and acceptability of implementing a Suicide Prevention Package (SuPP) within an existing task-shifted depression intervention. This K01 lays the groundwork for a future R01 to scale a package for multi-level suicide prevention strategies that can be integrated into community based mental health programs, particularly targeting individuals living in low- resourced settings. As the model is designed to be easily adapted and integrated, we anticipate the findings will be valuable for all researchers looking to improve population health and mental health services in disadvantaged settings.

抽象的 自杀是全球死亡率的主要贡献者，在低 - 资源设置。孕产既是自杀思想和行为的受保护和风险因素。在 围产期，妇女增加了自杀意念的风险，并经历了更高的暴力率和 暴力死亡。考虑到自杀率上升，围产期对母子和儿童的重要性，以及 不断扩展任务转移计划以治疗常见的精神障碍，有关键而紧迫的 需要将实施策略纳入这些程序中的自杀检测和转诊。尽管 任务班的心理健康干预措施已培训了同伴社区成员，以成功地提供低位 在临床护理访问有限的强度干预措施中，同龄人仍然是未开发的资源来提供 在最需要的情况下，预防自杀性支持。该奖项的目标是扩大 候选人的专业知识，以进行与自杀预防研究有关的独立临床试验的专业知识。 在低资源，高需求的设置中集成了社区传递的检测和响应。通过 候选人的专家团队，课程工作，研讨会和会议出勤的结构化精神训练 将在预防自杀研究中发展新的能力，包括：（1）纵向培训 罕见事件的分析（2）实施科学方法和研究设计，以适用于自杀 预防干预措施； （3）临床试验管理技能，包括预防自杀的道德行为 资源紧张的环境中的研究成为一名由NIH资助的独立研究者。博士。唐娜 Spiegelman，Joanna Maselko，Atif Rahman，Paul Pfeiffer和Byron Powell（与巴基斯坦咨询公司一起） 委员会）将指导并建议候选人实现这些目标。拟议的研究将 （1）随着时间的流逝，复发自杀念头对母亲的流行病学和健康影响，（2） 表征自杀构想的关键特征和最终确定研究的干预套件组件 背景和（3）进行试验临床试验，以评估实施自杀的可行性和可接受性 在现有的任务转移抑郁干预措施中的预防软件包（SUPP）。这个K01放置 未来R01的基础工作，以扩展可以进行多层次自杀策略的包装 集成到社区心理健康计划中，特别是针对生活在低 - 资源设置。由于该模型被设计为易于调整和集成，因此我们预计这些发现 对于所有希望改善人口健康和精神卫生服务的研究人员都将是有价值的 处境不利的设置。