Effectiveness trial of youth suicide prevention delivered by teen peer leaders

青少年同伴领袖预防青少年自杀的有效性试验

• 批准号: 7947950
• 负责人: Peter A Wyman
• 金额: $ 60.02万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-28 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7947950
• 关键词: Accounting; Address; Adolescent; Adult; Affect; Age; Arts; Attitude; Behavioral; Cause of Death; Cessation of life; Clinical Trials Design; Communication; Communities; Coupled; Data; Diffusion; Distress; Drug usage; Educational Curriculum; Effectiveness; Ethnic Origin; Evaluation; Exercise; Female; Funding; Gatekeeping; Health Knowledge, Attitudes, Practice; Health behavior; Health system; Hylobates Genus; Influentials; Internet; Intervention; Knowledge; Link; Measures; Mediating; Mediator of activation protein; Mental Health; Mental Health Services; Mentors; Methodology; Methods; Modeling; Moods; New York; North Dakota; Pathway Analysis; Patient Self-Report; Peer Group; Perception; Performance; Population; Prevention program; Preventive Intervention; Problem behavior; Proliferating; Protocols documentation; Public Health; Race; Randomized; Randomized Controlled Trials; Recording of previous events; Recruitment Activity; Reliance; Research Infrastructure; Risk; Risk Factors; Rural; Rural Community; Sampling; Schools; Screening procedure; Secure; Services; Site; Social Network; Source; Students; Subgroup; Substance abuse problem; Suicide; Suicide attempt; Suicide prevention; Surveys; Teenagers; Testing; Time; Training; United States National Center for Health Statistics; Victimization; Violence; Waiting Lists; Work; Youth; age group; base; coping; cost; density; design; effective intervention; effectiveness trial; help-seeking behavior; high risk; high school; intervention effect; male; medical attention; novel; peer; peer influence; programs; public health relevance; reducing suicide; research study; response; social; social integration; social networking website; strength training; substance abuse prevention; suicidal; suicidal adolescent; suicidal behavior; suicide rate; young adult

DESCRIPTION (provided by applicant): This project responds to the need for (1) scientifically rigorous evaluations of interventions to prevent suicide in adolescents, and for (2) school-based suicide prevention programs that are suitable for rural and underserved communities where there is a scarcity of mental health services. Suicide accounts for more deaths among 10 - 24 year olds in the US than all natural causes combined; each year 5 - 9% of adolescents attempt suicide and 700,000 require medical attention. In most rural regions, adolescent suicide rates are 2 - 10 times above the US national average. This proposal seeks RO1 funding for a randomized controlled trial to evaluate the effectiveness of the Sources of Strength (SoS) intervention in reducing rates of attempted suicide among adolescents in rural communities. SoS builds social-ecological protective influences across a full population of high school students to reduce the likelihood that vulnerable youth will become suicidal and connects suicidal youth to capable adults at school and in the community. Trained 'peer opinion leaders' change the norms of students throughout their schools regarding the acceptability of suicide, help-seeking and youth-adult communication by conducting a set of well-defined messaging activities with ongoing adult mentoring. This approach draws on the major influence of adolescent peers that is powerful enough to affect drug use, sexual practices and other health behaviors. We have completed work to prepare SoS for a large scale trial, including conducting a preliminary study using a randomized design in 18 schools showing that the intervention modifies the norms of students school-wide about suicide and help seeking, with the largest changes occurring among suicidal youth. For the proposed 5-year study, 36 rural high schools in New York and North Dakota will be randomly assigned to immediate SoS or wait-list control conditions. We will survey students in the schools over 18 months to (1) compare intervention and control levels of self-reported suicide attempts, (2) determine differences in impact for low- and high-risk groups, (3) test multiple hypothesized mediators of SoS impact on reducing suicide attempts from our intervention causative model, (4) use social network methods in a subset of schools to identify network mediators of SoS impact, the extent of dissemination of peer-to-peer messages, and evaluate the efficiency of the current strategy for identifying student peer leaders. This project can have a positive public health impact through the potential to prepare a cost-effective intervention that can be implemented safely in diverse communities and is effective in reducing suicidal behaviors among adolescents. PUBLIC HEALTH RELEVANCE: This proposed 5-year project can have a positive public health impact by preparing Sources of Strength (SoS), a school-based suicide prevention intervention, for expansion as a cost-effective program that can be implemented safely in diverse communities and is effective in reducing suicidal behaviors among adolescents. The proposed study can also contribute to knowledge needed to strengthen social-ecological protective influences across a full population of high school students by peer opinion leaders to change the norms of students through their schools and reduce suicidal behaviors.

描述（由申请人提供）：该项目满足以下需求：(1) 对预防青少年自杀的干预措施进行科学严格的评估，以及 (2) 适合农村和服务欠缺社区的基于学校的自杀预防计划精神卫生服务匮乏。在美国 10 至 24 岁人群中，自杀造成的死亡人数比所有自然原因死亡人数的总和还多；每年有 5 - 9% 的青少年试图自杀，其中 700,000 人需要医疗护理。在大多数农村地区，青少年自杀率是美国全国平均水平的 2 至 10 倍。 该提案寻求 RO1 资助一项随机对照试验，以评估力量来源 (SoS) 干预措施在降低农村社区青少年自杀未遂率方面的有效性。 SoS 在全体高中生中建立社会生态保护影响，以降低弱势青少年自杀的可能性，并将自杀青少年与学校和社区中有能力的成年人联系起来。训练有素的“同侪意见领袖”通过开展一系列明确的信息活动和持续的成人指导，改变了全校学生对自杀、寻求帮助和青少年与成人沟通的可接受性的规范。这种方法利用了青少年同龄人的主要影响力，这种影响力足以影响吸毒、性行为和其他健康行为。我们已经完成了为大规模试验准备 SoS 的工作，包括在 18 所学校进行了一项随机设计的初步研究，表明该干预措施改变了全校学生关于自杀和寻求帮助的规范，其中最大的变化发生在有自杀倾向的学生中青年。 在拟议的 5 年研究中，纽约和北达科他州的 36 所农村高中将被随机分配到立即 SoS 或候补名单控制条件。我们将在 18 个月内对学校的学生进行调查，以 (1) 比较自我报告的自杀企图的干预和控制水平，(2) 确定对低风险和高风险群体的影响差异，(3) 测试多种假设的中介因素根据我们的干预因果模型，SoS 对减少自杀企图的影响，(4) 在一部分学校中使用社交网络方法来识别 SoS 影响的网络中介、点对点消息的传播程度，并评估网络中介的效率当前的识别学生同伴领袖的策略。该项目可以通过制定具有成本效益的干预措施来产生积极的公共卫生影响，该干预措施可以在不同社区安全实施，并有效减少青少年的自杀行为。 公共卫生相关性：拟议的 5 年期项目可以通过准备力量来源 (SoS)（一种以学校为基础的自杀预防干预措施）来扩展为一项具有成本效益的计划，可以在不同社区安全实施，从而对公共卫生产生积极影响并能有效减少青少年的自杀行为。拟议的研究还可以为同行意见领袖加强对全体高中生的社会生态保护影响所需的知识做出贡献，从而通过学校改变学生的规范并减少自杀行为。