Caring Texts: A Strength-based, Suicide Prevention Trial in 4 Native Communities

关爱文本：在 4 个原住民社区进行的基于力量的自杀预防试验

基本信息

批准号：
10328292
负责人：
KATHERINE ANNE COMTOIS
金额：
$ 89.98万
依托单位：
WASHINGTON STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-06-01 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10328292
关键词：
Address Adult Age Alaska Alaska Native American Indians Attention Behavior Caring Cause of Death Cessation of life Communication Methods Communities Country Data Effectiveness Electronic Mail Environmental Wind Event Evidence based intervention Exhibits Family Feeling suicidal Friends Future Goals Grant Grief reaction Health care facility Health system Healthcare Systems Hospitalization Human Individual Intervention Law Enforcement Letters Life Mediating Mental disorders Minority Groups Not Hispanic or Latino Outcome Participant Persons Population Population Characteristics Prevention program Prevention strategy Prevention trial Process Randomized Controlled Trials Research Resources Risk Risk Factors Rivers Role Rural Schools Services Site Site Visit Social isolation Social support Substance abuse problem Suicide Suicide attempt Suicide prevention Supportive care Surgeon Telephone Text Messaging Theoretical model Time Trauma Work aged base cohesion compare effectiveness cost cultural values design experience follow-up health disparity high risk improved interest intervention effect mortality native youth non-Native northern plains prevent programs protective factors public health relevance racism randomized trial reducing suicide resilience rural Americans social social exclusion standard care suicidal behavior suicidal individual suicidal risk suicide rate text messaging intervention theories treatment as usual underserved minority urban area young adult

项目摘要

DESCRIPTION (provided by applicant): High rates of suicide are endemic in American Indian and Alaska Native (AI/AN) young adults. A recent study found that rates for young AI/AN adults in the Northern Plains and in Alaska are more than 4 times higher than for Whites of the same age in the same regions. Building social connections is a key goal of suicide prevention. One validated theoretical model asserts that belonging to a group is a fundamental human need. When this need is thwarted by social isolation or inadequate social support, a desire for death emerges. Studies of suicide prevention in AI/ANs underscore the cultural importance of connection to friends, family, caring neighbors, and community leaders. These traditions of community cohesion can be leveraged to protect young AI/AN adults against suicidal ideation and behavior. Caring Contacts is a suicide prevention program that supplements standard care by promoting human connectedness. People at risk for suicide often lose contact with the healthcare system and receive no follow-up care. For 1 year after an initial presentation, Caring Contacts seeks out such individuals to send messages expressing care, concern, and interest. It is the only intervention shown to prevent suicide in any population in a randomized, controlled trial. Based on an almost two year collaborative process with four tribal partners as part of a pilot grant, we have designed a locally feasible, culturally appropriate Caring Contacts intervention that will use text messaging, the dominant communication method for young AI/AN adults. This study uses a randomized, controlled trial (RCT) to evaluate this approach to suicide prevention in 1,200 high-risk AI/ANs aged 18-34 from our four partner communities. Our Specific Aims are to: 1) Compare the effectiveness of usual care (control) to the control condition plus caring text messages (intervention) for reducing suicidal ideation, suicide attempts, and suicide- related hospitalizations. 2) Evaluate social connectedness as a mediating factor for the effect of Caring Contacts via text message on suicidality. The US Surgeon General's National Strategy for Suicide Prevention identifies connectedness to others as the primary protective factor against suicidality.53 By adapting and disseminating the Caring Contacts approach, which has demonstrated effectiveness in non-Native populations, our study will evaluate a low-cost, sustainable intervention for addressing the profound disparity of suicide risk experienced by young adult AI/ANs.

描述（由申请人提供）：美洲印第安人和阿拉斯加原住民 (AI/AN) 年轻人的自杀率很高。最近的一项研究发现，北部平原和阿拉斯加的年轻成人 AI/AN 发病率比同一地区同龄白人高出 4 倍多。建立社会联系是预防自杀的一个关键目标。一个经过验证的理论模型断言，归属于一个群体是人类的基本需求。当这种需求因社会孤立或社会支持不足而受到阻碍时，对死亡的渴望就会出现。对 AI/AN 自杀预防的研究强调了与朋友、家人、有爱心的邻居和社区领袖保持联系的文化重要性。可以利用这些社区凝聚力的传统来保护年轻的 AI/AN 成年人免受自杀意念和行为的影响。 Caring Contacts 是一项自杀预防计划，通过促进人际关系来补充标准护理。有自杀风险的人往往与医疗保健系统失去联系，也得不到后续护理。在初次演示后的一年内，关爱联系人会寻找此类人员发送表达关心、关心和兴趣的信息。这是随机对照试验中显示的唯一可以预防任何人群自杀的干预措施。作为试点拨款的一部分，我们与四个部落合作伙伴进行了近两年的合作，设计了一种当地可行的、文化上合适的关怀接触干预措施，该干预措施将使用短信，这是年轻 AI/AN 成年人的主要沟通方式。本研究采用随机对照试验 (RCT) 来评估来自我们四个合作社区的 1,200 名 18-34 岁高危 AI/AN 的自杀预防方法。我们的具体目标是： 1) 比较常规护理（控制）与控制条件加关怀短信（干预）对于减少自杀意念、自杀企图和自杀相关住院治疗的有效性。 2）评估社会联系作为短信关怀联系人对自杀影响的中介因素。美国卫生局局长的国家自杀预防战略将与他人的联系确定为防止自杀的主要保护因素。 53 通过采用和传播关怀接触方法（该方法已在非本地人群中证明有效），我们的研究将评估一种低成本、解决自杀问题的可持续干预措施年轻成人 AI/AN 经历的风险。