SAFETY-A for Promoting Equity in Suicide Prevention Outcomes in Schools

SAFETY-A 促进学校自杀预防成果的公平

基本信息

批准号：
10677768
负责人：
ANNA Shan-Lai LAU
金额：
$ 23.63万
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：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10677768
关键词：
Accident and Emergency department Acute Address Administrator Adolescent Age American Asian Americans Caregivers Caring Case Series Characteristics Clinical Cluster randomized trial Coercion Cognitive Therapy Collaborations Communication Continuity of Patient Care Data Death Rate Detection Disparity Distress Emergency department visit Emotions Equity Ethnic Population Family Feedback Feeling suicidal Funding Hospitalization Hybrids Intervention Investigation Latina Latinx Low income Mental Health Mental Health Services Methods Not Hispanic or Latino Outcome Parents Perception Persons Phase Policies Prevention Protocols documentation Provider Randomized Reporting Research Resource-limited setting Resources Risk Risk Assessment Schools Structure Students Suicide attempt Suicide prevention Symptoms Teenagers Testing Time Training Trust United States National Institutes of Health Youth acceptability and feasibility design disparity reduction effectiveness/implementation trial emotional distress ethnic disparity ethnic minority ethnic minority population evidence base follow-up health service use human centered design hybrid type 1 trial implementation barriers implementation evaluation implementation outcomes implementation science implementation strategy improved internalized stigma medical specialties minority children minority student peer pilot trial primary outcome prototype provider adherence racial disparity racial minority population racial population randomized trial response school district secondary outcome service providers skills training social stigma suicidal suicidal adolescent suicidal behavior suicidal morbidity suicidal risk therapy development workforce needs

项目摘要

PROJECT SUMMARY Ethnic minority adolescents, including Asian American and Latinx adolescents are at increased risk for suicidal thoughts and attempts compared to their Non-Hispanic White (NHW) peers, yet they are less likely to receive mental health services (MHS) after their suicide risk is identified. Although school-based MHS reduce access barriers, racial disparities persist within suicide prevention efforts in schools. The proposed study will adapt Safe Alternatives For Teens and Youth – Acute (SAFETY-A) for implementation in low-resourced school districts to target putative mechanisms underlying disparities in MHS use following youth suicide risk detection. SAFETY-A will be adapted to reduce mistrust of MHS, internalized stigma, and concealment of youth emotional distress that drive poor engagement in MHS among Asian American and Latinx students and families. Furthermore, SAFETY-A delivery parameters and implementation strategies will be adapted to fit the organizational context of school district policies and protocols, resource constraints, and workforce needs. The proposed intervention development study will include three phases. First, stakeholders will be engaged to design adaptations to the intervention and implementation strategy. Provider, youth and caregiver input will be gathered using human-centered design approaches to adapting the SAFETY-A intervention content to address disparities mechanisms. School district leaders, school administrators, and MHS providers will help to develop a tailored implementation strategy to fit local training and support needs across a range of district contexts. Second, a prototyping case series will inform iterative refinements of SAFETY-A in one school district. Third, a pilot controlled trial will randomize school districts to the timing of implementation to provide preliminary data on the impact of SAFETY-A on proposed mechanisms of action (trust in MHS, stigma, youth emotion communication) and the primary outcome of MHS utilization and the secondary outcome of suicidal thoughts and behaviors across racial/ethnic groups. Mixed methods will be used to assess implementation outcomes of provider adherence, and perceptions of feasibility, acceptability and fit. The proposed project will provide preliminary data on feasibility and potential impacts on putative mechanisms to propose a definitive Hybrid Type 1 trial to test SAFETY-A as an intervention to reduce racial/ethnic disparities in MHS utilization among suicidal youth.

项目摘要包括亚裔美国人和拉丁裔青少年在内的少数民族青少年的风险增加与非西班牙裔白人（NHW）同行相比确定自杀风险后，接受心理健康服务（MHS）。尽管基于学校的MHS减少了访问障碍，种族差异持续在学校的自杀预防工作中。拟议的研究将适应青少年和青年的安全替代方案 - 急性（安全A）用于在低资源学校实施在青年自杀风险检测之后，以MHS的分配为基础的定义机制的地区。安全A将适应以减少MHS的Millsrust，内部化的污名和掩盖青年情绪困扰，导致亚裔美国人和拉丁裔学生的MHS参与不佳，以及家庭。此外，安全A的交付参数和实施策略将适用于学区政策和协议，资源约束和劳动力需求的组织环境。拟议的干预开发研究将包括三个阶段。首先，利益相关者将订婚设计适应干预和实施策略。提供者，青年和照顾者的意见将使用以人为本的设计方法来收集安全A的干预内容地址分布机制。学区领导，学校管理员和MHS提供商将有助于制定量身定制的实施策略，以适合各个地区的本地培训和支持需求上下文。其次，原型案例系列将为A Safee A School A School的迭代改进提供信息区。第三，试验对照试验将将学区随机，以实施时机提供关于安全A对拟议的行动机制的影响的初步数据（对MHS，污名，青年的信任情绪交流）和MHS利用的主要结果和自杀的次要结果种族/族裔群体的思想和行为。混合方法将用于评估实施提供者遵守的结果，以及对可行性，可接受性和合适性的看法。拟议的项目将提供有关可行性和对推定机制的潜在影响的初步数据，以提出确定性混合1型测试安全A的试验 - 作为减少MHS利用率种族/种族差异的干预措施在自杀青年中。