Caring Texts: A Strength-based, Suicide Prevention Trial in 4 Native Communities

关爱文本：在 4 个原住民社区进行的基于力量的自杀预防试验

基本信息

批准号：
10328292
负责人：
KATHERINE ANNE COMTOIS
金额：
$ 89.98万
依托单位：
WASHINGTON STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-06-01 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10328292
关键词：
Address Adult Age Alaska Alaska Native American Indians Attention Behavior Caring Cause of Death Cessation of life Communication Methods Communities Country Data Effectiveness Electronic Mail Environmental Wind Event Evidence based intervention Exhibits Family Feeling suicidal Friends Future Goals Grant Grief reaction Health care facility Health system Healthcare Systems Hospitalization Human Individual Intervention Law Enforcement Letters Life Mediating Mental disorders Minority Groups Not Hispanic or Latino Outcome Participant Persons Population Population Characteristics Prevention program Prevention strategy Prevention trial Process Randomized Controlled Trials Research Resources Risk Risk Factors Rivers Role Rural Schools Services Site Site Visit Social isolation Social support Substance abuse problem Suicide Suicide attempt Suicide prevention Supportive care Surgeon Telephone Text Messaging Theoretical model Time Trauma Work aged base cohesion compare effectiveness cost cultural values design experience follow-up health disparity high risk improved interest intervention effect mortality native youth non-Native northern plains prevent programs protective factors public health relevance racism randomized trial reducing suicide resilience rural Americans social social exclusion standard care suicidal behavior suicidal individual suicidal risk suicide rate text messaging intervention theories treatment as usual underserved minority urban area young adult

项目摘要

DESCRIPTION (provided by applicant): High rates of suicide are endemic in American Indian and Alaska Native (AI/AN) young adults. A recent study found that rates for young AI/AN adults in the Northern Plains and in Alaska are more than 4 times higher than for Whites of the same age in the same regions. Building social connections is a key goal of suicide prevention. One validated theoretical model asserts that belonging to a group is a fundamental human need. When this need is thwarted by social isolation or inadequate social support, a desire for death emerges. Studies of suicide prevention in AI/ANs underscore the cultural importance of connection to friends, family, caring neighbors, and community leaders. These traditions of community cohesion can be leveraged to protect young AI/AN adults against suicidal ideation and behavior. Caring Contacts is a suicide prevention program that supplements standard care by promoting human connectedness. People at risk for suicide often lose contact with the healthcare system and receive no follow-up care. For 1 year after an initial presentation, Caring Contacts seeks out such individuals to send messages expressing care, concern, and interest. It is the only intervention shown to prevent suicide in any population in a randomized, controlled trial. Based on an almost two year collaborative process with four tribal partners as part of a pilot grant, we have designed a locally feasible, culturally appropriate Caring Contacts intervention that will use text messaging, the dominant communication method for young AI/AN adults. This study uses a randomized, controlled trial (RCT) to evaluate this approach to suicide prevention in 1,200 high-risk AI/ANs aged 18-34 from our four partner communities. Our Specific Aims are to: 1) Compare the effectiveness of usual care (control) to the control condition plus caring text messages (intervention) for reducing suicidal ideation, suicide attempts, and suicide- related hospitalizations. 2) Evaluate social connectedness as a mediating factor for the effect of Caring Contacts via text message on suicidality. The US Surgeon General's National Strategy for Suicide Prevention identifies connectedness to others as the primary protective factor against suicidality.53 By adapting and disseminating the Caring Contacts approach, which has demonstrated effectiveness in non-Native populations, our study will evaluate a low-cost, sustainable intervention for addressing the profound disparity of suicide risk experienced by young adult AI/ANs.

描述（由申请人提供）：在美洲印第安人和阿拉斯加本地（AI/AN）年轻人中，高自杀率是特有的。最近的一项研究发现，在北部平原和阿拉斯加的年轻AI/A成年人的比率是同一地区同龄的白人的4倍以上。建立社交联系是预防自杀的关键目标。一个验证的理论模型断言，属于一个群体是人类的基本需求。当社会隔离或社会支持不足挫败这种需求时，就会出现对死亡的渴望。 AI/ANS中预防自杀的研究强调了与朋友，家人，关怀邻居和社区领袖联系的文化重要性。可以利用这些社区凝聚力的传统来保护年轻的AI/AN成年人免受自杀念头和行为。关怀联系人是一项预防自杀计划，可以通过促进人类联系来补充标准护理。有自杀风险的人通常会失去与医疗保健系统的联系，并且没有获得随访护理。在初次演讲后的1年中，有爱心的联系人寻求此类人发送表达护理，关注和兴趣的消息。这是在一项随机，对照试验中显示出任何人群自杀的唯一干预措施。根据试点赠款的一部分，基于与四个部落合作伙伴的一个近两年的合作流程，我们设计了一种本地可行的，具有文化适当的关怀联系人干预，该干预将使用文本消息传递，这是年轻AI/AN成人的主要沟通方法。这项研究使用一项随机，对照试验（RCT）评估了从我们四个合作伙伴社区的1,200名高危AI/ANS中的自杀预防方法。我们的具体目的是：1）将常规护理（控制）的有效性与控制条件以及关怀文本消息（干预）进行比较，以减少自杀念头，自杀未遂和与自杀相关的住院治疗。 2）评估社会联系，作为通过自杀的短信关怀联系人的效果的中介因素。美国外科医生的自杀预防战略将与他人的联系确定为抵抗自杀性的主要保护因素。53通过调整和传播关怀的接触方法，这在非本地人群中表现出了有效性，我们的研究将评估一项低成本，评估一项低成本，，，，，一项低成本，可持续干预以解决自杀的严重差异年轻的成人AI/ANS经历的风险。