RFA-CE-22-004, Optimizing Firearm Suicide Prevention in Healthcare

RFA-CE-22-004，优化医疗保健中的枪支自杀预防

• 批准号: 10558911
• 负责人: Julie Elissa Richards
• 金额: $ 64.96万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10558911
• 关键词: RFA; CE; 22; 004; Optimizing

Suicide accounts for 60% of U.S. firearm deaths, with even higher rates in Alaska, Colorado, and Washington. Firearms are the most common method of suicide in the U.S., and firearm access is linked to increased suicide risk. Most people who die by suicide see a health care provider in the year prior to death, thus clinical providers have important opportunities to intervene with patients at risk for firearm suicide. Though firearm access is relevant to patients’ health and safety, routine questions about firearm access are uncommon and there is a dearth of evidence available to guide implementation of promising clinical practices for firearm suicide prevention, including firearm access assessment and provider- initiated dialogue about limiting access. Our team has begun to address this evidence gap in a series of innovative studies focused on firearm access assessment. Specifically, we established that adult primary care and mental health patients will answer standardized questions about firearms, and highlighted how limiting screening questions to patients receiving mental health care misses many at risk patients. We also elicited patient and clinician concerns about firearm access assessment and described how concerns about privacy, autonomy, and ownership rights may be addressed by their suggestions. This study will build on these findings and address the critical need for patient-centered strategies to identify and engage patients at high-risk of firearm suicide through Objective One of CDC’s RFA-CE- 22-004: Research to inform the development of innovative and promising firearm injury/mortality prevention strategies. Human Centered Design and Community Based Participatory Research approaches will support Option B for new data collection activities and the implementation of prevention activities. We will employ the Discover, Design and Build, and Test framework to inform implementation strategies in three healthcare systems serving ~1.3 million people in communities with high rates of firearm ownership and suicide. We will: 1 (DISCOVER): Elicit patient, clinician, and leader perspectives on clinical practices for identifying and engaging individuals at risk of firearm suicide, and to identify opportunities for practice improvement via retrospective chart review and descriptive analyses of medical records. 2 (DESIGN/BUILD): Partner with clinical and quality improvement staff and leadership to design intervention strategies to support evidence-based clinical practices for firearm suicide prevention. 3 (TEST): Pilot test clinical intervention strategies in three healthcare systems to demonstrate feasibility, acceptability, and usability; and to measure reach. Our work will lay a strong foundation for future dissemination of patient-centered firearm suicide prevention practices and evaluations of effectiveness.

自杀占美国枪支死亡的60％，在阿拉斯加，科罗拉多州和 华盛顿。枪支是美国自杀的最常见方法，枪支访问链接 增加自杀风险。大多数因自杀而死的人都会在前一年看到医疗保健提供者 死亡，因此临床提供者有重要的机会来干预枪支风险的患者 自杀。尽管枪支访问与患者的健康和安全有关，但有关枪支的例行问题 访问并不常见，并且有证据死亡以指导实施诺言 预防枪支自杀的临床实践，包括枪支访问评估和提供商 - 启动有关限制访问的对话。我们的团队已经开始解决这一证据差距 创新研究的重点是枪支访问评估。具体来说，我们确定了成年人 初级保健和心理健康患者将回答有关枪支的标准化问题，以及 强调将筛查问题限制在接受精神卫生保健的患者中如何错过了许多处于危险之中的人 患者。我们还引起了有关枪支访问评估的患者和临床问题的关注，并描述了 对隐私，自主权和所有权的担忧如何通过其建议解决。 这项研究将以这些发现为基础，并满足以患者为中心的策略的关键需求 通过疾病预防控制中心的RFA-CE-识别并吸引患者以高风险的枪支自杀。 22-004：研究旨在发展创新和有前途的枪支伤害/死亡率的研究 预防策略。以人为中心的设计和基于社区的参与性研究 方法将支持选项B用于新的数据收集活动和实施 预防活动。我们将采用发现，设计和建造和测试框架来告知 三个医疗保健系统的实施策略，在社区中为约130万人提供服务 枪支所有权和自杀率高。我们将： 1（发现）：引起有关临床实践的患者，临床和领导者的观点 并吸引有枪支自杀风险的人，并确定实践机会 通过回顾性图表审查和医疗记录的描述性分析改进。 2（设计/构建）：与临床和质量改进的员工以及设计领导者合作 支持基于证据的临床实践的干预策略，以预防枪支自杀。 3（测试）：三种医疗保健系统中的试验测试临床干预策略以证明 可行性，可接受性和可用性；并衡量覆盖范围。 我们的工作将为以后以患者为中心的枪支自杀奠定坚实的基础 预防实践和有效性评估。