Quantifying Real-world Effectiveness of Mental Health Interventions for Suicide Prevention in At-risk Adolescent and Transitional Age Youth

量化高危青少年和过渡时期青年心理健康干预措施预防自杀的现实有效性

• 批准号: 10394352
• 负责人: Philip S Wang
• 金额: $ 29.53万
• 依托单位: CAMBRIDGE HEALTH ALLIANCE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10394352
• 关键词: Adolescent; Adolescent and Young Adult; Age; Behavior; Black race; Caring; Clinic; Clinical; Clinical Treatment; Cognitive Therapy; Communities; Community Practice; Comparative Effectiveness Research; Control Groups; Criminal Justice; Data; Data Set; Dimensions; Dose; Early treatment; Effectiveness; Effectiveness of Interventions; Evidence based treatment; Face; Food; Frequencies; Goals; Health Alliance; Hispanic; Individual; Institution; Insurance; International Classification of Disease Codes; Intervention; Language; Linguistics; Link; Measures; Mediating; Mental Health; Mental disorders; Minority Groups; National Institute of Mental Health; Neighborhoods; Outcome; Outpatients; Patients; Persons; Pharmaceutical Preparations; Police; Population; Population Heterogeneity; Prevention; Prevention strategy; Psychopathology; Psychotherapy; Public Health; Quality of Care; Research; Research Methodology; Risk; Running; Sampling; Schools; Sequential Multiple Assignment Randomized Trial; Site; Specific qualifier value; Strategic Planning; Suicide; Suicide attempt; Suicide prevention; Testing; Thinking; Time; Treatment outcome; Visit; Work; Youth; aged; base; cohort; community based research; community based treatment; computerized; early screening; effective therapy; ethnic minority population; experience; follow-up; health data; high dimensionality; high risk; improved; innovation; marginalized community; minority children; practice setting; prevent; psychosocial; racial and ethnic; racial and ethnic disparities; reducing suicide; social health determinants; suicidal; suicidal adolescent; suicidal behavior; suicidal risk; suicide rate; treatment group; trend; underserved community; Adolescent; Adolescent and Young Adult; Age; Behavior; Black race; Caring; Clinic; Clinical; Clinical Treatment; Cognitive Therapy; Communities; Community Practice; Comparative Effectiveness Research; Control Groups; Criminal Justice; Data; Data Set; Dimensions; Dose; Early treatment; Effectiveness; Effectiveness of Interventions; Evidence based treatment; Face; Food; Frequencies; Goals; Health Alliance; Hispanic; Individual; Institution; Insurance; International Classification of Disease Codes; Intervention; Language; Linguistics; Link; Measures; Mediating; Mental Health; Mental disorders; Minority Groups; National Institute of Mental Health; Neighborhoods; Outcome; Outpatients; Patients; Persons; Pharmaceutical Preparations; Police; Population; Population Heterogeneity; Prevention; Prevention strategy; Psychopathology; Psychotherapy; Public Health; Quality of Care; Research; Research Methodology; Risk; Running; Sampling; Schools; Sequential Multiple Assignment Randomized Trial; Site; Specific qualifier value; Strategic Planning; Suicide; Suicide attempt; Suicide prevention; Testing; Thinking; Time; Treatment outcome; Visit; Work; Youth; aged; base; cohort; community based research; community based treatment; computerized; early screening; effective therapy; ethnic minority population; experience; follow-up; health data; high dimensionality; high risk; improved; innovation; marginalized community; minority children; practice setting; prevent; psychosocial; racial and ethnic; racial and ethnic disparities; reducing suicide; social health determinants; suicidal; suicidal adolescent; suicidal behavior; suicidal risk; suicide rate; treatment group; trend; underserved community

PROJECT SUMMARY AND ABSTRACT – Cambridge Health Alliance ALACRITY for Early Screening and Treatment of High Risk Youth (eSToRY) R34 - Quantifying real-world effectiveness of mental health interventions for suicide prevention in at- risk adolescent and transitional age youth Identifying effective suicide prevention strategies for racial/ethnic and language (REL)-diverse populations of youth at high risk of suicide has enormous public health importance. Suicide rates for persons aged 10–24 have increased by more than 50% over the last decade in nearly every state and for nearly every racial/ethnic minority group, with particularly concerning increases in suicide attempts among Black youth. In this project, we utilize a unique clinical-sociocontextual dataset of over 15,000 youth patients at high risk for suicide to conduct high-dimensional comparative effectiveness research (CER) of community-based mental health interventions in the prevention of self-injurious thoughts and behaviors among REL-diverse adolescents and transitional age youth. We leverage an enormous warehouse of clinical, insurance, criminal justice, individual- and neighborhood-level social determinants of health data to multi-dimensionally match treatment and control groups and assess the impact of differing community-based treatment regimes on suicidal outcomes. In Aim 1, we propose innovative comparative effectiveness research using a large retrospective clinical- sociocontextual dataset to identify effective treatments for suicide prevention, and how these differ across REL-diverse groups. In Aim 2, we identify a sub-sample of this cohort in the present day, following up our retrospective analysis with a computerized adaptive test analyzing current day suicidal outcomes, psychopathology, and measures social determinants of health and quality of care. This will allow for assessment of long-run treatment outcomes, and how unobserved variables may bias comparative effectiveness research results. This study lays the groundwork for two R01-level studies: 1) a larger CER trial of treatment regimes across multiple institutions; and 2) a sequential multiple assignment randomized trial (SMART) that evaluates the impact of systematic adaptation of treatment on suicide outcomes. The project will contribute to a better understanding of whether, how, when, and for whom to alter the duration, frequency, type, or delivery of treatments at pivotal steps in the episode of treatment, leading to interventions that will reduce the risk of suicidality in vulnerable REL-diverse populations.

项目摘要和摘要 - 剑桥健康联盟 早期筛查和治疗高风险青年（Estory）的痛苦 R34-量化心理健康干预措施对预防自杀的现实有效性 风险青少年和过渡年龄青年 确定有效的种族/种族和语言预防自杀策略（rel） 自杀风险高的青年具有巨大的公共健康重要性。 10-24岁的人的自杀率 在过去的十年中，几乎每个州和几乎每个种族/种族都增加了50％以上 少数群体尤其是关于黑人青年自杀企图的增加。在这个项目中， 我们利用了15,000名自杀风险高的青年患者的独特临床秘密文化数据集 对基于社区的心理健康进行高维比较有效性研究（CER） 涉嫌预防自治的思想和行为的干预措施 过渡年龄青年。我们利用临床，保险，刑事司法，个人的巨大仓库 以及邻里级别的健康数据社会决定者，以匹配多维的治疗和控制 小组并评估区分基于社区的治疗方案对自杀结果的影响。 在AIM 1中，我们提出了使用大型回顾性临床 - 社会上下文数据集，以识别预防自杀的有效治疗方法，以及它们之间的不同 回生多样性群体。 在AIM 2中，我们确定了当今该队列的一个子样本，跟随我们的回顾性分析 计算机化自适应测试分析了当前自杀结果，心理病理学和衡量社会 健康和护理质量的决定因素。这将允许评估长期治疗结果，并 未观察到的变量如何偏向比较有效性研究结果。 这项研究为两项R01级研究奠定了基础：1）跨越跨越治疗方案的CER试验 多个机构； 2）评估评估 系统适应治疗对自杀预后的影响。该项目将有助于更好 了解是否，如何，何时以及为谁改变持续时间，频率，类型或交付 治疗情节中关键步骤的治疗，导致干预措施将降低 弱势群体人群中的自杀性。