Disaggregating Asian Americans and Pacific Islanders to identify mechanisms of adolescent suicide risk: The role of school stressors, alcohol, sleep, and school/community contexts

分解亚裔美国人和太平洋岛民，以确定青少年自杀风险的机制：学校压力源、酒精、睡眠和学校/社区环境的作用

• 批准号: 10544534
• 负责人: Camillia K. Lui
• 金额: $ 20.18万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10544534
• 关键词: Administrator; Adolescent; Age; Alcohol consumption; Alcohols; Area; Asian Americans; Asian Indian; Attention; California; Cambodian; Cause of Death; Child; Chinese; Communities; Data; Data Analyses; Disadvantaged; Disparity; Drug usage; East Asian; Economic Conditions; Environment; Ethnic Origin; Ethnic Population; Feeling suicidal; Filipino; Future; Gender; Health behavior; Heterogeneity; Individual; Intervention; Japanese; Koreans; Link; Marijuana; Masks; Measures; Mediating; Mental Health; Methods; Minority; Modeling; National Institute of Mental Health; National Institute on Minority Health and Health Disparities; Not Hispanic or Latino; Pacific Islander; Perception; Performance; Population; Population Heterogeneity; Populations at Risk; Prevalence; Process; Public Health; Race; Recording of previous events; Reporting; Research; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Role; Sample Size; Schools; Sleep; Sleep Deprivation; Socioeconomic Status; Stress; Students; Subgroup; Suicide; Suicide attempt; Suicide prevention; Surveys; System; Variant; Vietnamese; adolescent suicide; alcohol effect; boys; bullying; density; educational atmosphere; ethnic minority population; experience; girls; health disparity; high risk; high risk population; lens; marijuana use; modifiable risk; novel; peer; protective factors; public health intervention; public health relevance; racial minority population; racial population; reducing suicide; resilience; resilience factor; response; screening; social; social culture; socioeconomics; southeast Asian; stressor; suicidal; suicidal adolescent; suicidal behavior; suicidal risk; suicide rate; teacher; theories

Abstract Adolescent suicide is a critical issue that warrants immediate attention since it is the leading cause of death among AAPI adolescents ages 15-19. As one of the most diverse U.S. racial/ethnic minority groups, AAPIs are often overlooked because as an aggregate, they appear to have lower rates than other racial/ethnic groups. When disaggregated, some AAPI groups show significantly higher suicide rates than non-Hispanic whites. Continuing to aggregate AAPIs will only perpetuate the hidden problems of adolescent suicide and mask AAPI's different ethnic group histories, settlement experiences, socioeconomic positions, and health behaviors, which may contribute to higher suicide risk. Recognizing the heterogeneity in AAPIs and their diverse sociocultural contexts, this study aims to examine individual- and contextual-level risk and protective factors that may influence and help explain variations in adolescent suicide risk in eight AAPI groups: Asian Indians, Chinese, Filipinos, Japanese, Koreans, Pacific Islanders, Southeast Asians (i.e., Hmong, Cambodians, Laotians), and Vietnamese. In this, we heed the NIMH and NIMHD's call for research to identify drivers of mental health disparities using a multilevel lens that links individuals to sociocultural environments and macrolevel influences. Applying the Social Ecological Model and informed by minority and stress process theories, our study investigates salient school- related stressors of academic performance and race-relevant bullying. We will examine the roles of alcohol use, marijuana use and insufficient sleep – the latter two rising in prevalence – as potentially modifiable responses to these stressors, that also vary in prevalence across AAPI subgroups and gender. Capitalizing on survey data from the largest U.S. school system and with the largest AAPI student population, this study will entail secondary data analysis of adolescent surveys linked with school administrator surveys of teacher/staff perceptions of school climate, school administrative data of student composition and academic performance, and community data of AAPI demographic and socioeconomic conditions. For each AAPI subgroup-by-gender, this study will address three aims: (1) examine the relationships between school-related stressors (i.e., poor grades, bullying) and suicide risk, and assess how these relationships vary by school and community contexts (i.e., school climate, co-ethnic density, disadvantage), (2) assess the extent to which alcohol use, marijuana use and sleep individually modify and mediate these associations with suicide risk, and (3) illuminate intervention levers by estimating the reduction in suicide risk at the population level associated with changes in stressors and risk behaviors, and the added reduction associated with enhanced protective contexts. This research will address novel questions about race-relevant stressors and risk behaviors on suicide risk, and how these mechanisms vary across the eight AAPI groups and gender. Findings will inform a mixed-methods R01 proposal to link these stressors and risk behaviors with psychopathological factors in order to gain a richer understanding of risk and resiliency mechanisms within schools and communities to best guide suicide interventions for AAPI adolescents.

抽象的 青少年自杀是一个值得立即关注的关键问题，因为它是导致死亡的主要原因 作为美国最多元化的种族/族裔群体之一，AAPI 群体在 15 至 19 岁之间 经常被忽视，因为总体而言，他们的发病率似乎低于其他种族/族裔群体。 分类后，一些亚太裔群体的自杀率明显高于非西班牙裔白人。 继续汇总 AAPI 只会使青少年自杀的隐藏问题长期存在，并掩盖 AAPI 的情况 不同族群的历史、定居经历、社会经济地位和健康行为， 认识到 AAPI 的异质性及其多样化的社会文化可能会导致更高的自杀风险。 背景，本研究旨在检查可能影响个人和背景水平的风险和保护因素 并帮助解释八个 AAPI 群体青少年自杀风险的差异：亚裔印度人、中国人、菲律宾人、 日本人、韩国人、太平洋岛民、东南亚人（即苗族、柬埔寨人、老挝人）和越南人。 在这方面，我们注意到 NIMH 和 NIMHD 呼吁开展研究，利用 将个人与社会文化环境和宏观影响联系起来的多层次镜头。 生态模型并以少数群体和压力过程理论为基础，我们的研究调查了突出的学校- 我们将研究酒精使用的作用， 吸食大麻和睡眠不足——后两者的流行率上升——作为潜在的可改变的应对措施 根据调查数据，这些压力源在亚太裔亚群体和性别中的流行程度也有所不同。 来自美国最大的学校系统和最多的 AAPI 学生群体，这项研究将需要中学 对青少年调查的数据分析与学校管理人员对教师/工作人员的看法的调查相联系 学校氛围、学生构成和学业成绩的学校行政数据以及社区 对于按性别划分的每个 AAPI 亚组，本研究将提供 AAPI 人口和社会经济状况的数据。 解决三个目标：(1) 检查与学校相关的压力源之间的关系（即成绩差、欺凌） 和自杀风险，并评估这些关系如何因学校和社区环境（即学校氛围、 种族密度、劣势），(2) 评估单独饮酒、吸食大麻和睡眠的程度 修改和调节这些与自杀风险的关联，以及（3）通过估计 与压力源和危险行为的变化相关的人群自杀风险的降低，以及 这项研究将解决与加强保护环境相关的新问题。 与种族相关的压力源和风险行为对自杀风险的影响，以及这些机制在八个群体中有何不同 AAPI 群体和性别的调查结果将为混合方法 R01 提案提供信息，以将这些压力源和风险联系起来。 具有心理病理因素的行为，以获得对风险和弹性的更丰富的理解 学校和社区内的机制，以最好地指导亚太裔青少年的自杀干预措施。