Experimental evaluation of a multi-site suicide intervention for youth during and after residential placement

寄宿安置期间和之后对青少年进行多地点自杀干预的实验评估

基本信息

批准号：
9935970
负责人：
Erin Godfrey
金额：
$ 64.41万
依托单位：
NEW YORK UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-23 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9935970
关键词：
18 year old Acute Address Administrator Adolescent Aftercare American Area Behavior Cancer and Suicide Caring Cause of Death Centers for Disease Control and Prevention (U.S.)Cessation of life Characteristics Child Welfare Cluster randomized trial Collaborations Common Data Element Communication Data Detection Dialectical behavior therapy Dimensions Disease Educational Status Effectiveness Effectiveness of Interventions Evaluation Feeling suicidal Fostering General Population Gold Heterogeneity Hour Human Resources Imprisonment Impulsivity Individual Infrastructure Intervention Justice Knowledge Legal Legal system Letters Life Literature Measures Medical Mental Health Modeling Moods New York New York City Outcome Personal Satisfaction Policies Population Prevention Prevention therapy Probability Procedures Protocols documentation Public Health Randomized Recommendation Recording of previous events Registries Research Research Personnel Resources Risk Site Structure Suicide Suicide prevention Surveys System Testing Thinking Time Training Training Programs Trauma United States United States National Institutes of Health Universities Vulnerable Populations Work Youth arm base burnout child services compare effectiveness coping demographics design effectiveness testing evidence base experience girls help-seeking behavior high risk ideation implementation science improved juvenile justice system knowledge base longitudinal analysis non-suicidal self injury preventive intervention response skills skills training substance use suicidal behavior suicidal morbidity suicidal risk suicide rate theories uptake

项目摘要

Abstract/Summary In response to the public health threat that suicide poses to American youth in general and incarcerated youth in particular, we propose a multi-year, multi-site, setting-level intervention in the New York City Juvenile Justice system. In partnership with the NYC Administration for Children's Services (ACS), we will experimentally evaluate an evidence-based staff-level training (S4L) to address youth suicidality during two critical points of contact for juvenile-justice involved youth: placement and post-release Aftercare. S4L combines training in Shield of Care (SOC), an evidence-based model for acute suicide detection training for juvenile justice staff, with evidence-based suicide prevention skill-building training informed by dialectical-behavior therapy for adolescents at risk for suicide ideation, behavior, and non-suicidal self-injury (NSSI). We will compare the effectiveness of S4L to a training as usual control condition (control), and to a condition in which we provide monthly on-site coaching to staff to support the acquisition and implementation of S4L skills (S4L+). The intervention will be implemented as part of ACS's usual staff-training procedures. The need for intervention is urgent at this time due to recent state-level policy shifts that will increase the number youth in these sites and heighten their suicide risk. S4L and S4L+ will be evaluated using a 3-arm cluster-randomized design with the full population of non-secure placement (NSP)/Aftercare sites (N=30 sites; N=1800 youth, 30% girls). These sites are sole infrastructure for long-term confinement in NYC. NSP/Aftercare sites will be randomized to control (N=10 sites; 600 youth), S4L (N=10 sites; 600 youth), and S4L+ (N=10 sites; 600 youth) conditions. We test the effectiveness of S4L compared to S4L+ and control on improving suicidal behavior, suicidal ideation, and NSSI; mental health outcomes (internalizing, externalizing and substance use); and correlates of suicide/mental health (impulsivity, mood, and coping). In addition, we test the extent to which site-level implementation characteristics (e.g., proportion of staff trained; average amount of detection and prevention activities); site and staff-level structural characteristics (e.g., prior training, burnout); and individual youth characteristics (e.g., demographics; trauma history) moderate S4L and S4L+ effectiveness. Youth outcome data on suicidal behavior, suicidal ideation, NSSI, and mental health problems and their correlates will be tracked longitudinally for 1 year. In response to the FOA, outcomes will be assessed via evidence-based measures that capture dimensional facets of disorder in line with NIH's common data elements and recommendations by the National Action Alliance for Suicide Prevention. Site-level intervention moderators will be measured by staff survey and administrative data. This project aims to expand the scientific knowledge base on suicide prevention and intervention in high-stakes youth settings and provide empirically-based guidance regarding the feasibility and scalability of staff training and coaching into different juvenile justice systems and jurisdictions. This project leverages an existing collaboration and has the full support of ACS.

摘要/总结应对自杀对美国青少年和被监禁青少年造成的公共健康威胁我们特别建议对纽约市少年司法部门进行多年、多地点、环境层面的干预系统。我们将与纽约市儿童服务管理局 (ACS) 合作，进行实验评估基于证据的员工级别培训（S4L），以解决青少年在两个关键时刻的自杀问题涉及少年司法的青少年的联系方式：安置和释放后的善后照顾。 S4L 结合了培训护理之盾 (SOC) 是一种针对少年司法工作人员进行急性自杀检测培训的循证模型，通过辩证行为疗法进行基于证据的自杀预防技能建设培训处于自杀意念、自杀行为和非自杀性自伤 (NSSI) 风险的青少年。我们将比较 S4L 对常规控制条件（控制）训练的有效性，以及我们提供的条件每月对员工进行现场辅导，以支持 S4L 技能 (S4L+) 的获取和实施。这干预措施将作为 ACS 常规员工培训程序的一部分实施。干预的必要性是由于最近国家级政策的转变，这些地点的年轻人数量将增加，因此目前非常紧迫增加他们的自杀风险。 S4L 和 S4L+ 将使用 3 臂集群随机设计进行评估，其中非安全安置 (NSP)/善后护理场所的全部人口（N = 30 个场所；N = 1800 名青少年，30% 为女孩）。这些这些场所是纽约市长期监禁的唯一基础设施。 NSP/善后护理地点将被随机分配控制（N=10 个站点；600 名青少年）、S4L（N=10 个站点；600 名青少年）和 S4L+（N=10 个站点；600 名青少年）条件。我们测试 S4L 与 S4L+ 和对照相比在改善自杀行为、自杀意念、和 NSSI；心理健康结果（内化、外化和物质使用）；以及相关的自杀/心理健康（冲动、情绪和应对）。此外，我们还测试了站点级别的程度实施特征（例如，受过培训的工作人员比例；平均检测和预防数量活动）;场所和员工层面的结构特征（例如，事先培训、倦怠）；和个别青年特征（例如人口统计、创伤史）中等 S4L 和 S4L+ 有效性。青年成果有关自杀行为、自杀意念、NSSI 和心理健康问题及其相关性的数据将纵向追踪1年。为了响应 FOA，结果将通过基于证据的评估进行评估根据 NIH 的通用数据元素捕获紊乱的维度方面的措施，以及国家预防自杀行动联盟的建议。站点级干预主持人将通过工作人员调查和行政数据来衡量。该项目旨在扩展科学知识以高风险青年环境中的自杀预防和干预为基础，并提供基于经验的关于不同少年司法工作人员培训和指导的可行性和可扩展性的指导系统和管辖权。该项目利用了现有的合作并得到了 ACS 的全力支持。