Integrating the Youth Nominated Support Team (YST) with CBT for Black Youth with Acute Suicide Risk

将青年提名支持团队 (YST) 与针对有急性自杀风险的黑人青年的 CBT 相结合

• 批准号: 10573542
• 负责人: Cynthia (Cindy) Ewell Foster
• 金额: $ 23.4万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10573542
• 关键词: Accident and Emergency department; Acute; Address; Administrator; Adolescent; Adult; Age; American; Assessment tool; Black race; Caring; Cause of Death; Clergy; Clinic; Clinical Trials; Cognitive; Cognitive Therapy; Collaborations; Communities; Computer Assisted; Continuity of Patient Care; Counseling; County; Data; Development; Distress; Education; Effectiveness; Emergency department visit; Ethnic Population; European; Evidence based intervention; Family; Feeling suicidal; Friends; Health system; Hospitals; Hybrids; Individual; Institution; Intervention; Lead; Link; Mental Health; Mental Health Services; Michigan; Outcome; Outpatients; Parents; Pediatric Hospitals; Population; Prevention strategy; Procedures; Psychotherapy; Public Health; Randomized; Recommendation; Reporting; Research Methodology; Research Personnel; Risk; Risk Factors; Sampling; Schools; Self-Injurious Behavior; Social support; Suicide; Suicide attempt; Suicide prevention; Time; Training; United States Substance Abuse and Mental Health Services Administration; Youth; access disparities; adolescent suicide; clinical care; community based participatory research; design; effectiveness trial; emotion dysregulation; evidence base; feasibility trial; help-seeking behavior; high risk; implementation barriers; implementation framework; implementation/effectiveness; improved; innovation; mortality; pilot test; psychosocial; racial population; research and development; response; sobriety; suicidal; suicidal behavior; suicidal risk; suicide mortality; theories; therapy development

Project Abstract Recent data show alarming increases in suicide mortality among Black youth combined with concerning disparities in access to and engagement in outpatient mental health care. Despite this urgent need, there are no well-established psychosocial treatments for suicide risk with demonstrated effectiveness in Black youth. Commonly used approaches (e.g., CBT) tend to focus on intrapersonal factors associated with suicide-related distress, such as cognitive distortions and emotion dysregulation, with limited focus on interpersonal factors (e.g., connectedness, social support), which are recommended as a suicide prevention strategy, and may be specifically protective for Black youth. The Youth Nominated Support Team (YST) was designed to be adjunctive to treatment following an acute suicide crisis, is specifically focused on intrapersonal connections, and has been designated a “promising intervention” by SAMHSA. YST creates a team of youth- nominated adults who receive education and guidance, provide weekly supportive contacts for high-risk youth, and encourage youth participation in treatment. YST is the only individual-level suicide prevention strategy in the U.S. with evidence of association with reduced self-injury mortality; participation in YST is also linked to increased treatment utilization. In response to this urgent need and RFA-MH-22-125, the proposed project will use a community-based participatory research (CBPR) strategy to iteratively develop and pilot test a two- component psychosocial intervention, Cognitive-Behavioral Therapy for Suicide Prevention plus the Youth- Nominated Support Team (CBT-SP+YST) for adolescents, ages 12-17 years, following an ED visit for acute suicide risk. Given the paucity of intervention development research conducted with Black youth, the alarming increases in suicide mortality among Black youth, and the possibility that social support interventions may be particularly protective for Black youth, this initial development of CBT-SP+YST will focus on cultural tailoring for Black youth served by Detroit/Wayne County’s public mental health system. Embedded within a hybrid one effectiveness-implementation framework, we will 1) integrate an innovative scalable computer assisted version of YST (E-YST) with CBT-SP, tailoring intervention components based on input from community stakeholders, 2) conduct a feasibility pilot and 3) conduct a pilot RCT to examine theorized mechanisms of action, youth outcomes, intervention feasibility/acceptability, and barriers to implementation in this population of publicly insured Black youth. Completion of the proposed study is the first step towards a larger-scale effectiveness trial, which will be facilitated by the innovative computer-assisted E -YST platform. The integration and tailoring of these two strategies has the potential to address an urgent public health concern while capitalizing on the inherent strengths found in the families, schools, and community institutions that surround Black youth.

项目摘要 最近的数据显示，黑人青年的自杀死亡率令人震惊 进入和参与门诊精神卫生保健方面的差异。尽管需要这种迫切需要 在黑人青年中，没有公认的自杀风险的社会心理治疗。 常用的方法（例如CBT）倾向于关注与自杀有关的人际因素 困扰，例如认知扭曲和情绪失调，对人际关系因素的关注有限 （例如，联系，社会支持），建议作为预防自杀策略，可能是 专门为黑人青年保护。青年提名的支持团队（YST）被设计为 急性自杀危机后治疗的辅助治疗专门针对人际联系， 并已被Samhsa指定为“有希望的干预”。 YST创建了一支由青年提名的团队 接受教育和指导的成年人，为高风险青年提供每周的支持联系，以及 鼓励青年参与治疗。 YST是唯一的个人预防自杀策略 美国有与自我伤害死亡率降低相关的证据；参与YST也链接到 增加的治疗利用。为了应对这种迫切需求和RFA-MH-22-125，拟议的项目将 使用基于社区的参与研究（CBPR）策略进行迭代开发和试点测试两次 组成的社会心理干预，预防自杀的认知行为疗法以及青年 在ED访问Acute之后 自杀风险。考虑到黑人青年进行的干预发展研究很少，令人震惊 黑人青年的自杀死亡率增加，社会支持干预措施可能是 CBT-SP+YST的最初发展特别是针对黑人青年的保护 底特律/韦恩县公共心理健康系统服务的黑人青年。嵌入混合动力 有效性实施框架，我们将1）集成了创新的可扩展计算机辅助版本 基于社区利益相关者的意见，YST（e-YST）与CBT-SP，裁缝干预组件 2）进行可行性飞行员和3）进行试点RCT以检查作用的理论机制，青年 结果，干预可行性/可接受性以及公开人群的实施障碍 保险的黑人青年。拟议研究的完成是迈向更大级别效果的第一步 试验，该试验将由创新的计算机辅助E -YST平台编写。整合和 这两种策略的裁缝有可能在资本化的同时解决公共健康问题 在围绕黑人青年的家庭，学校和社区机构中发现的继承优势。