Project 3

项目3

基本信息

批准号：
10406823
负责人：
Joan Rosenbaum Asarnow
金额：
$ 25.38万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
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：
2022-05-01 至 2027-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10406823
关键词：
Adolescence Adverse event Affect Algorithms Area Attitude Behavior Caring Categories Cause of Death Centers for Disease Control and Prevention (U.S.)Cessation of life Clinical Data Data Science Depression and Suicide Detection Discrimination Dose Effectiveness Emergency department visit Enhancement Technology Event Exposure to Family Feeling suicidal Financial Hardship Food Friends Goals Health Status Hospitalization Housing Individual Intervention Knowledge Latinx Lead Life Stress Los Angeles Low income Mediating Medical Mental Depression Mental Health Methods Modeling Outcome Phase Population Prevention Protocols documentation Randomized Research Risk Risk Factors Risk Management Safety Sampling Science Security Self-Injurious Behavior Series Services Severities Site Social support Stress Students Suicide Suicide attempt Suicide prevention Symptoms Testing Theoretical model Time Triage Underrepresented Minority United States Update Work adaptive intervention anxiety treatment base clinical care college community college digital intervention early life adversity effectiveness evaluation emerging adult evidence base group intervention high risk ideation improved indexing intervention effect mobile computing non-suicidal self injury prediction algorithm predictive modeling prevent preventive intervention primary outcome prognostic algorithm prognostic model protective factors prototype racial and ethnic rapid detection reducing suicide risk prediction safety and feasibility screening secondary outcome skills social determinants standard of care substance use suicidal suicidal behavior suicidal individual suicidal morbidity suicidal risk treatment center treatment response young adult

项目摘要

Project 3 Abstract The overall Project 3 goal is to advance science and clinical care for preventing suicide and self-harm and strengthen knowledge for reaching our national objectives of reducing suicide deaths and attempts.22 Within the context of the Center treatment model, “Screening and Treatment for Anxiety and Depression” (STAND), Project 3 extends the clinical targets of STAND to reducing suicide and self-harm risk with the goals of enhancing STAND effectiveness and benefits, and offering a scalable suicide/self-harm prevention model for community colleges. Recognizing disparities in mental health outcomes and access to evidence-based care, we focus on East Los Angeles Community College (ELAC), a community college site in a diverse, low-income area in Los Angeles. Using the Signature Project sample (N=1000) and methods, Project 3 seeks to: 1) enhance risk detection through developing/evaluating algorithms for identifying indicators of “SU/SH risk states” that emerge prior to the onset of suicidal/self-harm (SU/SH) behavior, and provide opportunities to deliver “just-in-time” interventions to prevent suicidal/self-harm episodes; 2) evaluate the effectiveness of STAND with treatment tier/level assigned and adapted based on data-driven algorithms, as compared to symptom severity, on suicide/self-harm outcomes; and 3) enhance the effectiveness of STAND for suicide/self-harm prevention by augmenting STAND with a technology-enhanced suicide prevention intervention (TE-SPI) that combines intervention components with demonstrated benefits in prior research. These include: safety planning; a digital intervention (BRITE app) that prompts safety plan use, skills, and hope; and caring contacts. The TE-SPI will be pre-tested and adapted for the Center population during Years 1 & 2, providing data on safety, feasibility, acceptability, and intervention effects. In Years 3-5, 420 students selected for need (STAND Tiers III or II) will be randomly assigned to either the TE-SPI plus STAND with Usual Risk Management (URM), or STAND with URM. We test the hypothesis that the TE-SPI group, relative to URM, will show: increased treatment engagement/contacts (i.e. app, STAND); lower risk of suicide/self-harm events; greater improvement in severity of suicidality; lower levels of suicide/self- harm related adverse events (e.g. hospitalizations, ED visits); and that increased treatment engagement leads to improved suicide/self-harm outcomes. Primary and secondary outcomes respectively are: suicide/self-harm events (including suicide attempts, unclear and nonsuicidal self-harm/NSSI); and an ordinal suicidality scale with categories of none, ideation, intent/plan, suicidal behavior, suicide attempts.

项目3摘要总体项目3的目标是提高科学和临床护理，以防止自杀和自我伤害和增强知识以达到我们减少自杀死亡和企图的国家目标。22 中心治疗模型的背景，“焦虑和抑郁症的筛查和治疗”（展位），项目 3扩展了立场的临床目标，以减少自杀和自我伤害风险，并具有增强立场的目标有效性和收益，并为社区大学提供可扩展的自杀/自我伤害预防模型。认识到心理健康成果中的分布和获得循证护理的分配，我们专注于东洛斯 Angeles社区学院（ELAC），位于洛杉矶潜水员，低收入地区的社区学院。使用签名项目样本（n = 1000）和方法，项目3寻求：1）通过开发/评估算法，以识别发作前出现的“ SU/SH风险状态”的指标自杀/自我伤害（SU/SH）行为，并提供了提供“及时”干预措施以防止的机会自杀/自我伤害情节； 2）用分配的治疗层/水平评估支架的有效性根据数据驱动的算法，与症状严重程度相比，根据自杀/自我伤害结果进行了调整； 3）通过用A增强立场来增强自杀/自我伤害的有效性技术增强的自杀预防干预（TE-SPI）将干预组件与在先前的研究中证明了好处。其中包括：安全计划；数字干预（Brite应用）提示安全计划使用，技能和希望；并携带联系人。 TE-SPI将进行预先测试并改编在1和2年度的中心人口，提供有关安全性，可行性，可接受性和干预的数据效果。在3 - 5年中，被选为需要的420名学生（立场III或II级）将被随机分配给任何一个 Te-Spi Plus具有通常的风险管理（URM），或与URM站在一起。我们检验了以下假设相对于URM，TE-SPI组将显示：增加的治疗参与/接触（即应用程序，站立）；降低自杀/自我伤害事件的风险；自杀严重程度的改善；较低的自杀/自杀与HARN相关的不良事件（例如住院，ED访问）；而增加的治疗参与线索改善自杀/自我伤害结果。初级和次要结果分别是：自杀/自我伤害事件（包括自杀企图，不清楚和非自杀自我伤害/NSSI）；以及一个有序的自杀量表无类别，思想，意图/计划，自杀行为，自杀企图。