The National Center for Health and Justice Integration for Suicide Prevention

国家预防自杀健康与司法一体化中心

基本信息

批准号：
10441870
负责人：
Brian Kenneth Ahmedani
金额：
$ 324.69万
依托单位：
MICHIGAN STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-22 至 2027-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10441870
关键词：
911 call Acute Address Admission activity Area Awareness Big Data Biometry Caring Client Communities County Criminal Justice Data Data Linkages Detection Diffusion Effectiveness Effectiveness of Interventions Funding Future General Population Goals Health Health system Healthcare Healthcare Systems Individual Information Systems Infrastructure Intercept Intervention Investigational Therapies Jail Justice Life Link Manic Disorder Mental Health Methods Modeling Morbidity - disease rate Movement National Institute of Mental Health Outcome Pathway interactions Patients Persons Police Population Populations at Risk Prevention Prevention approach Prisons Provider Racial Equity Records Research Resources Risk Risk Factors Risk Marker Structure Suicide Suicide prevention System Target Populations Testing Therapeutic community technique Time Vulnerable Populations Woman Work base biomedical informatics cost effectiveness court data integration effectiveness evaluation effectiveness implementation study experience health data health disparity health plan high risk implementation science improved innovation learning strategy men mortality multiple data sources novel parole probation reducing suicide response screening severe mental illness social metrics stressor substance use suicidal morbidity suicidal risk trait

项目摘要

Justice-involved individuals have high rates of trait, state, and precipitating risk factors for suicide, account for a significant proportion of U.S. suicides each year, and many are not well-connected to care. The National Center for Health and Justice Integration for Suicide Prevention (NCHATS): (1) uses contact with the justice system (e.g., police contact, arrest) as a novel indicator of suicide risk in the general population; (2) demonstrates how big data systems that efficiently track justice involvement can be linked to health system records and scaled to identify individuals at risk for suicide and connect them to care; and (3) examines effectiveness and scalability of suicide prevention approaches using these methods. Center projects are hybrid effectiveness-implementation studies that examine effectiveness, cost-effectiveness, and scalability of suicide prevention activities triggered through linkage of justice and health data. Given that contact with the justice system is a sign of risk for suicide, big data integration across justice/health systems to flag movement between systems (and therefore suicide risk) provides a novel method of identifying suicide risk in the general population. This approach does not require collecting new data from this hard-to-reach population. Rather, it sets up strategies to efficiently link existing data and to test methods to respond. This is an innovative and potentially scalable approach to identify/address suicide risk for individuals not well-connected with standard health care. The Center is innovative in that it: (1) establishes a suicide prevention intervention effectiveness base for a large and high-risk target population, conducting (a) 2 of only 3 fully-powered suicide prevention RCTs in justice populations, and (b) the largest RCTs of any intervention for any condition in a justice-involved population to date; (2) develops and manualizes strategies for scalability and sustainment -- understudied areas of implementation science; (3) uses contact with the justice system as a novel indicator of suicide risk in the general population; (4) uses sociometric identification of key individuals to promote diffusion and dissemination of Center approaches; (5) demonstrates how efficient, generalizable health and justice system big data linkage is achieved and can be used to automate suicide risk identification and response across health and justice systems at scale. This is extremely rarely done in practice and never before tested as a method of improving health outcomes in justice populations. By incorporating the few cases of which we are aware into this Center, we are poised to rapidly advance the field. Center aims are to: (1) Evaluate effectiveness and cost-effectiveness of suicide prevention approaches that use justice contacts as markers of risk and health/justice system data linkage to provide scalable ways to alert providers of this risk; (2) Maximize scalability, sustainability, relevance, and dissemination of identified approaches and identify, refine, and manualize scalability/sustainment strategies to be fully tested in future trials; and (3) Promote national research and practice capacity in suicide prevention at justice intercepts. Partners include jails, police, health plans, healthcare systems, courts, judges, community corrections, racial equity, and lived experience.

参与正义的个人具有较高的特质、状态和诱发自杀风险因素，占每年在美国自杀的人中所占比例很大，其中许多与护理无关。国家中心预防自杀的健康与司法一体化 (NCHATS)：(1) 利用与司法系统的联系（例如，警方联系、逮捕）作为普通人群自杀风险的新指标； (2) 演示如何有效跟踪司法参与的大数据系统可以与卫生系统记录相关联并扩展到识别有自杀风险的人，并将他们联系到护理机构； (3) 检查有效性和可扩展性使用这些方法预防自杀的方法。中心项目是有效性与实施的混合体引发的研究旨在检验自杀预防活动的有效性、成本效益和可扩展性通过司法和健康数据的联系。鉴于与司法系统接触是自杀风险的迹象，跨司法/卫生系统的大数据集成，以标记系统之间的移动（因此自杀风险）提供了一种识别普通人群自杀风险的新方法。这种方法不需要从这个难以接触到的人群中收集新数据。相反，它制定了有效链接现有数据的策略并测试响应方法。这是一种创新且具有潜在可扩展性的方法来识别/解决与标准医疗保健联系不紧密的个人的自杀风险。该中心的创新之处在于：（1）为大量高危目标人群建立自杀预防干预有效性基础，在司法人群中开展 (a) 仅有的 3 项全面自杀预防随机对照试验中的 2 项，以及 (b) 规模最大的随机对照试验迄今为止对参与司法的人群的任何状况进行了任何干预； (2) 开发和手册化可扩展性和维持性战略——实施科学的未充分研究领域； (3) 使用接触司法系统作为普通人群自杀风险的新指标； (4) 使用社会计量识别促进中心方法传播和传播的关键人物； (5) 演示如何有效，实现了普遍的健康和司法系统大数据链接，可用于自动化自杀风险卫生和司法系统的大规模识别和应对。这在实践中是极其罕见的以前从未作为改善司法人群健康结果的方法进行过测试。通过合并我们在该中心了解到的案例很少，我们准备迅速推进该领域。中心的目标是 (1) 评估利用司法联系的自杀预防方法的有效性和成本效益作为风险标记和健康/司法系统数据链接，以提供可扩展的方式来提醒提供者这种风险； (2) 最大限度地提高已确定方法的可扩展性、可持续性、相关性和传播性，并确定、完善、并手动制定可扩展性/维持策略，以便在未来的试验中进行全面测试； (3) 促进国家司法拦截中预防自杀的研究和实践能力。合作伙伴包括监狱、警察、卫生部门计划、医疗保健系统、法院、法官、社区矫正、种族平等和生活经验。