Project 3

项目3

基本信息

批准号：
10406823
负责人：
Joan Rosenbaum Asarnow
金额：
$ 25.38万
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：
2022
资助国家：
美国
起止时间：
2022-05-01 至 2027-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10406823
关键词：
Adolescence Adverse event Affect Algorithms Area Attitude Behavior Caring Categories Cause of Death Centers for Disease Control and Prevention (U.S.)Cessation of life Clinical Data Data Science Depression and Suicide Detection Discrimination Dose Effectiveness Emergency department visit Enhancement Technology Event Exposure to Family Feeling suicidal Financial Hardship Food Friends Goals Health Status Hospitalization Housing Individual Intervention Knowledge Latinx Lead Life Stress Los Angeles Low income Mediating Medical Mental Depression Mental Health Methods Modeling Outcome Phase Population Prevention Protocols documentation Randomized Research Risk Risk Factors Risk Management Safety Sampling Science Security Self-Injurious Behavior Series Services Severities Site Social support Stress Students Suicide Suicide attempt Suicide prevention Symptoms Testing Theoretical model Time Triage Underrepresented Minority United States Update Work adaptive intervention anxiety treatment base clinical care college community college digital intervention early life adversity effectiveness evaluation emerging adult evidence base group intervention high risk ideation improved indexing intervention effect mobile computing non-suicidal self injury prediction algorithm predictive modeling prevent preventive intervention primary outcome prognostic algorithm prognostic model protective factors prototype racial and ethnic rapid detection reducing suicide risk prediction safety and feasibility screening secondary outcome skills social determinants standard of care substance use suicidal suicidal behavior suicidal individual suicidal morbidity suicidal risk treatment center treatment response young adult

项目摘要

Project 3 Abstract The overall Project 3 goal is to advance science and clinical care for preventing suicide and self-harm and strengthen knowledge for reaching our national objectives of reducing suicide deaths and attempts.22 Within the context of the Center treatment model, “Screening and Treatment for Anxiety and Depression” (STAND), Project 3 extends the clinical targets of STAND to reducing suicide and self-harm risk with the goals of enhancing STAND effectiveness and benefits, and offering a scalable suicide/self-harm prevention model for community colleges. Recognizing disparities in mental health outcomes and access to evidence-based care, we focus on East Los Angeles Community College (ELAC), a community college site in a diverse, low-income area in Los Angeles. Using the Signature Project sample (N=1000) and methods, Project 3 seeks to: 1) enhance risk detection through developing/evaluating algorithms for identifying indicators of “SU/SH risk states” that emerge prior to the onset of suicidal/self-harm (SU/SH) behavior, and provide opportunities to deliver “just-in-time” interventions to prevent suicidal/self-harm episodes; 2) evaluate the effectiveness of STAND with treatment tier/level assigned and adapted based on data-driven algorithms, as compared to symptom severity, on suicide/self-harm outcomes; and 3) enhance the effectiveness of STAND for suicide/self-harm prevention by augmenting STAND with a technology-enhanced suicide prevention intervention (TE-SPI) that combines intervention components with demonstrated benefits in prior research. These include: safety planning; a digital intervention (BRITE app) that prompts safety plan use, skills, and hope; and caring contacts. The TE-SPI will be pre-tested and adapted for the Center population during Years 1 & 2, providing data on safety, feasibility, acceptability, and intervention effects. In Years 3-5, 420 students selected for need (STAND Tiers III or II) will be randomly assigned to either the TE-SPI plus STAND with Usual Risk Management (URM), or STAND with URM. We test the hypothesis that the TE-SPI group, relative to URM, will show: increased treatment engagement/contacts (i.e. app, STAND); lower risk of suicide/self-harm events; greater improvement in severity of suicidality; lower levels of suicide/self- harm related adverse events (e.g. hospitalizations, ED visits); and that increased treatment engagement leads to improved suicide/self-harm outcomes. Primary and secondary outcomes respectively are: suicide/self-harm events (including suicide attempts, unclear and nonsuicidal self-harm/NSSI); and an ordinal suicidality scale with categories of none, ideation, intent/plan, suicidal behavior, suicide attempts.

项目3摘要项目 3 的总体目标是促进预防自杀和自残的科学和临床护理以及加强知识以实现减少自杀死亡和自杀未遂的国家目标。22 中心治疗模式的背景，“焦虑和抑郁的筛查和治疗”（STAND）项目 3 将 STAND 的临床目标扩展到降低自杀和自残风险，以增强 STAND 的目标有效性和好处，并为社区大学提供可扩展的自杀/自残预防模型。认识到心理健康结果和获得循证护理方面的差异，我们重点关注东洛杉矶洛杉矶社区学院 (ELAC) 是位于洛杉矶多元化低收入地区的一所社区学院。使用标志项目样本 (N=1000) 和方法，项目 3 旨在：1) 通过以下方式加强风险检测：开发/评估算法，用于识别发病前出现的“SU/SH 风险状态”指标自杀/自残 (SU/SH) 行为，并提供提供“及时”干预措施的机会，以预防自杀/自残事件；2) 评估 STAND 的有效性以及分配的治疗等级/级别；根据数据驱动的算法进行调整，与症状严重程度、自杀/自残结果进行比较； 3) 通过增强 STAND 来增强 STAND 预防自杀/自残的有效性技术增强的自杀预防干预（TE-SPI），将干预措施与先前研究的好处包括：已证实的安全规划；数字干预（BRITE 应用程序）提示安全计划的使用、技能和希望；以及对 TE-SPI 进行预先测试和调整。第一年和第二年的中心人口，提供有关安全性、可行性、可接受性和干预的数据在 3-5 年级，根据需要（STAND III 或 II）选择的 420 名学生将被随机分配到任一年级。 TE-SPI 加上 STAND 与通常风险管理 (URM)，或 STAND 与 URM 我们检验以下假设。相对于 URM，TE-SPI 组将显示：增加治疗参与/接触（即应用程序、STAND）；自杀/自残事件的风险降低；自杀/自残的严重程度得到更大程度的改善；与伤害相关的不良事件（例如住院、急诊就诊）以及治疗参与度的增加；改善自杀/自残结果的主要和次要结果分别是：自杀/自残。事件（包括自杀未遂、不明和非自杀性自残/NSSI）；以及自杀顺序量表无类别、意念、意图/计划、自杀行为、自杀企图。