NATIVE RISE-Risk Identification for Suicide and Enhanced care for Native Americans

NATIVE RISE-自杀风险识别和加强对美洲原住民的护理

• 批准号: 10643067
• 负责人: Emily Haroz
• 金额: $ 65.87万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-25 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10643067
• 关键词: Address; Administrator; Adult; Algorithms; American Indians; Apache Tribe; COVID-19 impact; COVID-19 pandemic; Caring; Case Management; Case Manager; Cessation of life; Chronic; Clinic; Clinical; Cluster randomized trial; Communities; Disparity; Effectiveness; Evidence based intervention; Exercise; Funding; Funding Opportunities; Genocides; Goals; Health; Health Personnel; Health Services; Health system; Healthcare; Healthcare Systems; Human Resources; Hybrids; Individual; Inequity; Intervention; Knowledge; Life; Mediator; Mental Health Services; Methods; Modeling; National Institute of Mental Health; Native Americans; Navajo; Patients; Population; Positioning Attribute; Predictive Analytics; Prevention; Prevention approach; Prevention program; Prevention strategy; Process; Provider; Qualitative Methods; Randomized; Research; Resources; Risk; Rural; Rural Community; Science; Service delivery model; Services; Strategic Planning; Suicide; Suicide attempt; Suicide prevention; System; Testing; Time; Translating; Trauma; Tribes; Trust; United States Indian Health Service; White Mountain Apache; Work; Workload; Youth; community based participatory research; cost; design; economic cost; effectiveness evaluation; enhanced care; evidence base; experience; health care service; health care settings; health disparity; health equity; high risk; implementation barriers; implementation intervention; implementation trial; improved; innovation; intervention cost; personalized care; pilot test; predictive modeling; prevention service; program costs; programs; racial population; reducing suicide; risk prediction; risk stratification; scale up; suicidal morbidity; suicidal risk; suicide rate; tool; tribal community; tribal healthcare; tribal member

PROJECT SUMMARY The Johns Hopkins Center for American Indian Health and its partners, the White Mountain Apache Tribe and Navajo Nation are uniquely positioned and prepared to advance suicide prevention science through the funding opportunity “Service-Ready Tools for Identification, Prevention and Treatment of Individuals at Risk for Suicide” (RFA-MH-21-110). Native American populations experience substantially higher rates of suicide and the sharpest increases over time of any racial group. These disparities are the legacy of colonization, attempted genocide, historical trauma, and ongoing injustices, including chronic underfunding of health care and mental health services. Despite these adversities, NAs have exercised tribal sovereignty to support some of the most innovative, practical, and effective approaches to suicide prevention. One such model, the Celebrating Life program (CL), a community-based suicide surveillance and case management system, developed originally by the White Mountain Apache Tribe (WMAT) and shown to help contribute to reductions in suicide attempts and deaths over time. The CL program is now being scaled through the Southwest Hub for Youth Suicide Prevention (U19MH113136). As this program has scaled, our pilot work has revealed barriers to implementation, including 1) challenges to risk identification, and 2) difficulties matching individuals’ level of risk to evidence-based interventions as a means to improve scarce resource efficiencies. To help overcome these barriers to implementation, NIMH funded our team to develop and pilot test NATIVE-RISE (U19MH113136-02S3). NATIVE-RISE is a systems-level strategy that leverages predictive analytics to enhance risk identification and integrates and improves the efficiency of local NA case managers who deliver brief contact interventions. The proposed project will leverage our team’s historic MOU with Indian Health Service (IHS) and decades-long trust-relationships with tribal partners to test NATIVE-RISE and its integration in partnership with three NA-serving health care settings through a Hybrid Type III stepped-wedge cluster randomized implementation trial. Specifically, this project aims to 1) optimize the implementation of NATIVE- RISE across three NA-serving health care settings, 2) determine the effectiveness of NATIVE-RISE at improving the reach of evidence-based suicide prevention services, and 3) describe the costs associated with implementing NATIVE-RISE to inform scale-up and sustainability. Our application address key priority populations for NIMH (NOT-MH-21-090) and is in line with NIMH’s strategic plan Objective 4.3. If results are achieved, NATIVE-RISE will become an effective and scalable approach that improves services to prevent suicide among NA populations and advances our understanding of how to implement predictive analytics and more personalized care for suicide prevention.

项目概要 约翰霍普金斯大学美洲印第安人健康中心及其合作伙伴白山阿帕奇部落和 纳瓦霍族拥有独特的地位并准备通过以下方式推进自杀预防科学： 资助机会“用于识别、预防和治疗有风险的个人的服务就绪工具” “自杀”（RFA-MH-21-110）美洲原住民的自杀率和自杀率要高得多。 随着时间的推移，这些差异是任何种族群体中增长最快的。 种族灭绝未遂、历史创伤和持续存在的不公正现象，包括长期医疗保健资金不足 尽管存在这些逆境，国家部落仍行使部落主权来支持一些人。 最具创新性、实用性和有效的自杀预防方法之一就是“自杀预防”。 庆祝生命计划（CL），一个基于社区的自杀监测和案件管理系统， 最初由白山阿帕奇部落 (WMAT) 开发，并被证明有助于减少排放 随着时间的推移， CL 计划正在通过西南中心扩大规模。 青少年自杀预防 (U19MH113136) 随着该计划的规模扩大，我们的试点工作揭示了阻碍青少年自杀的障碍。 实施，包括 1) 风险识别的挑战，以及 2) 与个人水平相匹配的困难 以证据为基础的干预措施作为提高稀缺资源效率的手段的风险。 这些实施，NIMH 资助我们的团队开发和试点测试屏障 NATIVE-RISE (U19MH113136-02S3) NATIVE-RISE 是一种系统级策略，利用预测分析来 加强风险识别并整合和提高本地 NA 案例经理的效率 拟议的项目将利用我们团队与 Indian Health 的历史性谅解备忘录。 服务 (IHS) 以及与部落合作伙伴长达数十年的信任关系，以测试 NATIVE-RISE 及其集成 通过混合 III 型阶梯楔形集群与三个为 NA 提供服务的医疗机构合作 具体来说，该项目旨在 1）优化 NATIVE- 的实施。 跨三个 NA 服务的医疗保健机构的 RISE，2) 确定 NATIVE-RISE 的有效性 提高基于证据的自杀预防服务的覆盖面，以及 3) 描述与以下相关的成本 实施 NATIVE-RISE 来告知规模化和可持续性我们的应用程序解决了关键优先事项。 NIMH 的人口（NOT-MH-21-090）并且符合 NIMH 的战略计划目标 4.3 如果结果是。 如果实现的话，NATIVE-RISE 将成为一种有效且可扩展的方法，可改善服务以预防 NA 人群中的自杀率，并增进了我们对如何实施预测分析和 为预防自杀提供更个性化的护理。