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 青少年自杀是一个关键问题，值得立即关注，因为这是死亡的主要原因 在15-19岁的AAPI青少年中。作为美国最多样化的种族/族裔少数群体之一，Aapis是 他们经常被忽视，因为作为一个总体，它们的价格似乎低于其他种族/族裔群体。 当分解时，一些AAPI组的自杀率明显高于非西班牙裔白人。 继续汇总的AAPI只会使青少年自杀和面具AAPI的隐藏问题永存 不同的种族历史，定居经验，社会经济地位和健康行为，这些行为 可能导致更高的自杀风险。认识到Aapis及其潜水员社会文化的异质性 背景下，本研究旨在检查可能影响的个人和上下文级别的风险和保护因素 并有助于解释八个AAPI群体中青少年自杀风险的变化：亚洲印第安人，中国，菲律宾人， 日本人，韩国，太平洋岛民，东南亚人（即苗族，柬埔寨人，老挝人）和越南语。 在这方面，我们听取了NIMH和NIMHD的呼吁进行研究，以确定心理健康分布的驱动力 多层镜头将个人与社会文化环境和宏观的影响联系起来。应用社会 生态模型并由少数群体和压力过程理论所告知，我们的研究调查了显着的学校 - 相关的学术表现压力源和与种族相关的欺凌。我们将研究饮酒的作用， 大麻使用和睡眠不足 - 后两种患病率上升 - 可能会改变 这些压力源在AAPI亚组和性别之间的流行率也有所不同。利用调查数据 从美国最大的学校系统和最大的AAPI学生群体中，这项研究将需要中学 与学校管理员对教师/员工看法有关的青少年调查的数据分析 学校攀登，学生成文和学业表现的学校行政数据以及社区 AAPI人口和社会经济条件的数据。对于每个AAPI亚组，本研究将 地址三个目的：（1）检查与学校相关的压力源之间的关系（即，成绩差，欺凌） 以及自杀风险，并评估这些关系如何因学校和社区环境而异（即学校攀登， 共同种族密度，缺点），（2）评估酒精使用，大麻使用和单独睡眠的程度 修改和调解这些与自杀风险的关联，（3）通过估计 与压力源和风险行为变化相关的人口水平上的自杀风险降低， 增加了与增强的保护性环境相关的还原。这项研究将解决有关 与种族相关的压力源和自杀风险的风险行为，以及这些机制在八个 AAPI群体和性别。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 具有心理病理学因素的行为，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最佳指导AAPI青少年的自杀干预措施。