Quantifying Real-world Effectiveness of Mental Health Interventions for Suicide Prevention in At-risk Adolescent and Transitional Age Youth

量化高危青少年和过渡时期青年心理健康干预措施预防自杀的现实有效性

• 批准号: 10205663
• 负责人: Philip S Wang
• 金额: $ 26.04万
• 依托单位: CAMBRIDGE HEALTH ALLIANCE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10205663
• 关键词: Adolescent; Adolescent and Young Adult; Age; Behavior; Caring; Clinic; Clinical; Clinical Treatment; Cognitive Therapy; Communities; Community Practice; Comparative Effectiveness Research; Control Groups; Criminal Justice; Data; Data Set; Dimensions; Dose; Early treatment; Effectiveness; Effectiveness of Interventions; Evidence based treatment; Face; Food; Frequencies; Goals; Health Alliance; Hispanics; Individual; Institution; Insurance; International Classification of Disease Codes; Intervention; Language; Linguistics; Link; Measures; Mediating; Mental Health; Mental disorders; Minority; Minority Groups; National Institute of Mental Health; Neighborhoods; Outcome; Outpatients; Patients; Persons; Pharmaceutical Preparations; Police; Population; Population Heterogeneity; Prevention; Prevention strategy; Psychopathology; Psychotherapy; Public Health; Quality of Care; Research; Research Methodology; Risk; Running; Sampling; Schools; Sequential Multiple Assignment Randomized Trial; Site; Specific qualifier value; Strategic Planning; Suicide; Suicide attempt; Suicide prevention; Testing; Thinking; Time; Treatment outcome; Visit; Work; Youth; aged; base; cohort; community based research; community based treatment; computerized; early screening; effective therapy; experience; follow-up; health data; high dimensionality; high risk; improved; innovation; practice setting; prevent; psychosocial; racial and ethnic; racial and ethnic disparities; reducing suicide; social health determinants; suicidal; suicidal adolescent; suicidal behavior; suicidal risk; suicide rate; treatment group; trend; underserved community

PROJECT SUMMARY AND ABSTRACT – Cambridge Health Alliance ALACRITY for Early Screening and Treatment of High Risk Youth (eSToRY) R34 - Quantifying real-world effectiveness of mental health interventions for suicide prevention in at- risk adolescent and transitional age youth Identifying effective suicide prevention strategies for racial/ethnic and language (REL)-diverse populations of youth at high risk of suicide has enormous public health importance. Suicide rates for persons aged 10–24 have increased by more than 50% over the last decade in nearly every state and for nearly every racial/ethnic minority group, with particularly concerning increases in suicide attempts among Black youth. In this project, we utilize a unique clinical-sociocontextual dataset of over 15,000 youth patients at high risk for suicide to conduct high-dimensional comparative effectiveness research (CER) of community-based mental health interventions in the prevention of self-injurious thoughts and behaviors among REL-diverse adolescents and transitional age youth. We leverage an enormous warehouse of clinical, insurance, criminal justice, individual- and neighborhood-level social determinants of health data to multi-dimensionally match treatment and control groups and assess the impact of differing community-based treatment regimes on suicidal outcomes. In Aim 1, we propose innovative comparative effectiveness research using a large retrospective clinical- sociocontextual dataset to identify effective treatments for suicide prevention, and how these differ across REL-diverse groups. In Aim 2, we identify a sub-sample of this cohort in the present day, following up our retrospective analysis with a computerized adaptive test analyzing current day suicidal outcomes, psychopathology, and measures social determinants of health and quality of care. This will allow for assessment of long-run treatment outcomes, and how unobserved variables may bias comparative effectiveness research results. This study lays the groundwork for two R01-level studies: 1) a larger CER trial of treatment regimes across multiple institutions; and 2) a sequential multiple assignment randomized trial (SMART) that evaluates the impact of systematic adaptation of treatment on suicide outcomes. The project will contribute to a better understanding of whether, how, when, and for whom to alter the duration, frequency, type, or delivery of treatments at pivotal steps in the episode of treatment, leading to interventions that will reduce the risk of suicidality in vulnerable REL-diverse populations.

项目摘要和摘要 – 剑桥健康联盟 ALACRITY 用于高危青少年的早期筛查和治疗 (eSToRY) R34 - 量化心理健康干预措施在预防自杀方面的现实有效性 青少年和过渡年龄青少年的风险 为不同种族/民族和语言 (REL) 的人群确定有效的自杀预防策略 自杀高危青少年对 10 至 24 岁人群的自杀率具有巨大的公共卫生重要性。 过去十年中，几乎每个州、几乎每个种族/族裔的人口数量都增加了 50% 以上 少数群体，特别是黑人青年自杀企图的增加。 我们利用超过 15,000 名自杀高危青年患者的独特临床社会背景数据集 进行基于社区的心理健康的高维比较有效性研究（CER） 预防 REL 多样化青少年自残想法和行为的干预措施 我们利用临床、保险、刑事司法、个人的巨大仓库。 和社区层面的健康数据社会决定因素，以多维匹配治疗和控制 群体并评估不同的社区治疗方案对自杀结果的影响。 在目标 1 中，我们提出使用大型回顾性临床研究进行创新的比较有效性研究 社会背景数据集，用于确定预防自杀的有效治疗方法，以及这些治疗方法在不同人群中有何不同 REL-多元化群体。 在目标 2 中，我们确定了当前该队列的一个子样本，并进行了回顾性分析 计算机化的适应性测试，分析当今的自杀结果、精神病理学和社会措施 这将有助于评估长期治疗结果，以及 未观察到的变量如何可能使比较有效性研究结果产生偏差。 这项研究为两项 R01 级研究奠定了基础：1）针对不同治疗方案进行的更大规模的 CER 试验 多个机构；2) 一项序贯多重分配随机试验（SMART），评估 系统性调整治疗对自杀结果的影响 该项目将有助于更好地改善自杀结果。 了解是否、如何、何时以及为谁改变持续时间、频率、类型或交付 在治疗过程中的关键步骤进行治疗，从而采取干预措施来降低风险 弱势 REL 多样化人群的自杀率。