Effectiveness and Implementation of a Peer Mentorship Intervention (PREVAIL) to Reduce Suicide Attempts Among High-Risk Adults

同伴辅导干预 (PREVAIL) 减少高危成年人自杀企图的有效性和实施

基本信息

批准号：
10379598
负责人：
Paul Nelson Pfeiffer
金额：
$ 37.88万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-19 至 2022-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10379598
关键词：
Address Administrative Supplement Admission activity Adult American Beds Budgets COVID-19 COVID-19 pandemic Cause of Death Censuses Characteristics Effectiveness Effectiveness of Interventions Enrollment Ensure Feeling hopeless Feeling suicidal Funding Future Goals Health system Healthcare Systems Hospitals Individual Infection Inpatients Institutional Review Boards Intervention Investments Length Measures Mental Health Mentorship Methods Modality Outcome Participant Patient Recruitments Patients Persons Protocols documentation Public Health Randomized Randomized Controlled Trials Recovery Research Design Risk Risk Factors Running Sampling Studies Site Social isolation Specialist Structure Suicide Suicide attempt Suicide prevention Telephone Time TimeLine Training Uncertainty base clinically significant coronavirus disease cost effective intervention effectiveness evaluation effectiveness implementation study effectiveness implementation trial experience high risk implementation intervention improved meetings novel pandemic disease peer peer support preventive intervention primary outcome recruit reducing suicide remote intervention social success suicidal behavior suicidal morbidity suicidal risk suicide rate

项目摘要

PROJECT ABSTRACT Suicide is a leading cause of death, and the approximately 1 million suicide attempts that occur in the US each year represent a major societal and public health burden. Individuals identified as high risk for suicide are often admitted for inpatient mental health treatment; however, there are few interventions known to reduce suicides or suicide attempts during the high-risk period after hospital discharge. Peer support is a novel intervention approach to address two empirically supported risk factors for suicide, thwarted belongingness and hopelessness, during high-risk periods. PREVAIL is a suicide prevention intervention developed in a prior study to be delivered by peer support specialists, individuals with a lived experience of mental health challenges who have achieved stable recovery and are trained to support others at risk. PREVAIL consists of 3 months of one-to-one sessions in which peer support specialists share their experiences related to suicide and engage in semi-structured discussions to improve hope and belongingness among recipients. The PREVAIL R01 effectiveness-implementation trial was funded to determine whether PREVAIL is effective at reducing suicide attempts and suicidal ideation, whether improvement in hopelessness and belongingness explain improvements in suicide-related outcomes, and to identify barriers and facilitators to implementation of PREVAIL by health systems. The trial had been successfully meeting its recruitment milestones until March 2020 when in-person recruitment at both participating inpatient units was stopped due to the COVID-19 pandemic. Over the course of the subsequent year new protocols were put into place to recruit patients remotely and eventually return to in-person recruitment; however, the number of admissions at each site and the rate of recruitment continues to be lower than prior to the pandemic. Due to the impact of COVID-19, the study will not be able to reach its original recruitment goal of 490 enrolled participants under the remaining budget and timeline. The recruitment shortfall, if not addressed, will adversely limit the power of the study to detect a difference with respect to the primary outcome of suicide attempts. To address the impact of COVID-19, we propose to add an additional recruitment site to achieve the original target enrollment of the PREVAIL trial and achieve adequate power to determine the effectiveness the peer specialist intervention for reducing suicide attempts. The additional site will be a 48-bed inpatient unit within the Henry Ford healthcare system, which was chosen in part because the study has already received institutional review board approval for the current Henry Ford recruitment site. By achieving our full study sample, we also propose to compare remote vs. in-person implementation of the intervention on measures of acceptability and suicidal ideation. Due to the COVID-19 pandemic, the PREVAIL intervention shifted from primarily in-person to primarily remote (phone or video) delivery with unclear effects. These analyses will provide important guidance for health system implementation of PREVAIL and other similar peer support interventions.

项目摘要自杀是死亡的主要原因，在美国发生了大约100万起自杀企图每年都代表着重大的社会和公共卫生负担。被确定为自杀风险的个人是经常接受住院的心理健康治疗；但是，已知减少的干预措施很少出院后的高风险期间，自杀或自杀企图。同伴支持是一本小说干预方法解决两个经验支持的自杀危险因素，挫败归属感和绝望，在高风险时期。盛行是预防自杀的干预措施研究由同伴支持专家提供的研究，具有精神健康经验的个人实现稳定康复并接受培训以支持他人处于危险中的挑战。盛行由3组成同伴支持专家分享与自杀有关的经验和进行半结构化讨论，以提高接受者之间的希望和归属感。盛行的R01有效性 - 实施试验资助以确定是否盛行有效地减少自杀企图和自杀念头归属感解释了与自杀相关结果的改善，并确定障碍和促进者卫生系统占上风。该审判已成功召集了其招聘在2020年3月的里程碑直到两个参与的住院单位的面对面招聘到19号大流行。在随后的一年中远程招募患者，并最终返回面对面招募；但是，入学次数每个地点和招募率持续低于大流行之前。由于影响 COVID-19，该研究将无法达到490名参与者的最初招聘目标剩余的预算和时间表。招聘短缺（如果没有解决的话）将不利地限制研究自杀未遂的主要结果的研究。为了解决Covid-19的影响，我们建议添加一个额外的招聘站点以实现原始盛行试验的目标入学率并获得足够的能力来确定同伴的有效性减少自杀企图的专业干预措施。附加站点将是一个48张床的住院单元亨利·福特医疗保健系统（Henry Ford Healthcare System），部分原因是该研究已经获得机构当前亨利·福特招聘网站的审查委员会批准。通过获得我们的完整学习样本，我们也提议比较远程与面对面实施的干预措施的干预措施自杀念头。由于199年的大流行，普遍的干预措施从主要的人身上转变为主要是远程（电话或视频）传递，并具有不清楚的效果。这些分析将提供重要的指导用于卫生系统的实施和其他类似的同伴支持干预措施。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Characterizing suicide-related self-disclosure by peer specialists: a qualitative analysis of audio-recorded sessions.

DOI：
10.1080/18387357.2021.2010585
发表时间：
2022
期刊：
ADVANCES IN MENTAL HEALTH
影响因子：
1.4
作者：
Klim, Casimir;Vitous, C. Ann;Keller-Cohen, Deborah;Vega, Eduardo;Forman, Jane;Lapidos, Adrienne;Abraham, Kristen M.;Pfeiffer, Paul N.
通讯作者：
Pfeiffer, Paul N.

Peer mentorship to reduce suicide attempts among high-risk adults (PREVAIL): Rationale and design of a randomized controlled effectiveness-implementation trial.

同伴指导减少高危成年人的自杀企图（PREVAIL）：随机对照有效性实施试验的基本原理和设计。

DOI：
10.1016/j.cct.2019.105850
发表时间：
2019
期刊：
Contemporary clinical trials
影响因子：
2.2
作者：
Lapidos,Adrienne;Abraham,KristenM;Jagusch,Jennifer;Garlick,James;Walters,Heather;Kim,HMyra;Vega,Eduardo;Damschroder,Laura;Forman,Jane;Ahmedani,Brian;King,CherylA;Pfeiffer,PaulN
通讯作者：
Pfeiffer,PaulN