Piloting a culturally adapted multilevel suicide prevention intervention in schools for Black youth and their families

在学校为黑人青少年及其家人试点适应文化的多层次自杀预防干预措施

• 批准号: 10598131
• 负责人: Janelle Renee Goodwill
• 金额: $ 20.5万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10598131
• 关键词: 14 year old; Administrator; Adolescent; African American student; Age; Asphyxia; Attitude; Belief; Binding; Black American; Black race; Cause of Death; Chicago; Child; Child Mental Health; Clinical Trials; Color; Communities; Complex; Data; Detection; Development; Disparity; Economics; Educational Curriculum; Effectiveness; Equity; Evaluation; Evidence based program; Familiarity; Family; Feedback; Feeling suicidal; Foundations; Frequencies; Future; Goals; Health Resources; Health Services Accessibility; High School Student; Hospitals; Human Resources; Individual; Inequity; Intervention; Interview; Knowledge; Link; Mediating; Mental Depression; Mental Health; Mental Health Services; Middle School Student; Parents; Perception; Persons; Positioning Attribute; Prevention program; Procedures; Race; Randomized; Randomized, Controlled Trials; Reporting; Research Personnel; Resources; Risk Factors; Sampling; School-Age Population; Schools; Shapes; Stigmatization; Students; Suicide; Suicide attempt; Suicide prevention; Testing; Training; Work; Youth; access disparities; children of color; cohort; community setting; design; eighth grade; evidence base; follow-up; help-seeking behavior; high school; ideation; insight; internalized stigma; junior high school; member; peer; pilot test; prevent; preventive intervention; programs; public health priorities; reducing suicide; response; service utilization; social media; social stigma; suicidal; suicidal risk; teacher; therapy design; treatment services; underserved community; university student

Project Summary/Abstract The goal of this proposed study is to pilot test and evaluate the preliminary effectiveness of a school-based suicide prevention intervention tailored specifically for Black youth and those connected to Black youth (e.g., families and school personnel). Suicide was recognized in 2018 as the 2nd leading cause of death for 10 to 14- year-old Black adolescents in the U.S., yet there are few evidence-based suicide prevention interventions designed to account for the cultural factors that influence Black youth's risks for suicidality. Further – although universal school-based suicide prevention programs have great potential to alleviate disparities in access to mental health resources – most school-based suicide prevention interventions are administered to high school students. Some researchers have begun to implement prevention interventions among middle school-aged youth, but we know little about the effect universal school-based suicide prevention interventions could have for Black students residing in underserved communities. To redress this gap, we propose modifying an existing intervention with culturally adapted content by conducting a pilot RCT to assess preliminary effectiveness, tolerability, and feasibility. The Signs of Suicide (SOS) program is a school-based intervention that has demonstrated reductions in suicide attempts among middle and high school students by identifying knowledge and attitudes towards depression and suicide as key mechanisms that mediate the relation between intervention participation and a significant reduction in suicide attempts. Thus, it is important to consider how prioritizing these two mechanisms – knowledge and attitudes towards depression and suicide – may differ for Black youth whose perceptions of knowledge and attitudes of suicide may be culturally bound and influenced by stigmatized beliefs regarding help-seeing for mental health concerns. Parents views about stigma and school personnel's familiarity with suicide prevention resources may also influence Black youth's knowledge and attitudes, thus affirming the necessity of a multilevel suicide prevention intervention. We therefore propose a cultural adaptation of the SOS program that aims to: 1) Tailor the SOS intervention videos to include culturally adapted strategies for navigating stigma of receiving mental health treatment; (2) Develop culturally adapted curricula that trains parents and school personnel to (a) recognize suicide risk factors for Black youth; and (b) refer students to local mental health treatment services; and (3) Conduct a pilot randomized controlled trial (n=300) to assess feasibility, tolerability, and acceptability of reducing suicidality among Black youth across three intervention conditions (standard SOS condition; culturally adapted SOS condition; culturally adapted SOS + parent and school personnel training condition). Pre-test scores will be compared at post-test, 3-month, and 1-year follow up. Results from this study will advance our understanding of factors that contribute to and protect against suicidality in Black youth, while also providing a foundation to test and refine study procedures to implement the intervention in a larger cohort of students.

项目摘要/摘要 这项拟议的研究的目的是试点测试和评估基于学校的初步有效性 专门针对黑人青年和与黑人青年有关的预防干预措施（例如， 家庭和学校人员）。自杀于2018年被认为是10至14-的第二大死亡原因 美国在美国有一年历史的黑人青少年，但几乎没有证据基于循证的自杀性干预措施 旨在说明影响黑人青年自杀风险的文化因素。虽然 普遍以学校为基础的自杀计划有很大的潜力减轻分配的机会 心理健康资源 - 大多数基于学校的自杀预防干预措施都是针对高中的 学生。一些研究人员已开始在中学期间实施预防干预措施 青年，但我们对普遍基于学校的自杀预防干预措施的影响一无所知 对于居住在服务不足的社区中的黑人学生。为了纠正这一差距，我们建议修改现有的 通过进行试验RCT来评估初步有效性，对文化适应的内容进行干预， 耐受性和可行性。自杀（SOS）计划的迹象是一项基于学校的干预措施 通过识别知识，在中学和高中生中表现出自杀企图的减少 并关注抑郁和自杀作为调解关系的关键机制 干预参与并大大减少自杀企图。那是重要的是要考虑如何 优先考虑这两种机制 - 知道并参加抑郁和自杀 - 可能有所不同 黑人青年对自杀的知识和出勤率的看法可能受到文化约束和影响 通过关于为心理健康问题提供帮助的污名化信念。父母对污名和 学校个人对自杀预防资源的熟悉也可能影响黑人青年的知识 并参加，从而影响多层次自杀预防干预的必要性。因此，我们提出 SOS计划的文化适应，目的是：1）量身定制SOS干预视频 具有文化适应的策略，以导致接受心理健康治疗的污名； （2）在文化上发展 改编的课程，培训父母和学校人员（a）认识黑人青年的自杀危险因素； （b）将学生推荐给当地的心理健康治疗服务； （3）进行飞行员随机控制 试验（n = 300）评估可行性，耐受性和降低黑人青年自杀性的可接受性 在三个干预条件下 改编的SOS +父母和学校人员培训条件）。测试前的分数将在测试后进行比较， 3个月和1年的随访。这项研究的结果将提高我们对贡献因素的理解 在黑人青年中预防自杀性，同时还为测试和完善研究提供了基础 在更大的学生中实施干预的程序。