Implementing a Brief Suicide Intervention for High Risk Youth with Front-Line Juvenile Justice Staff

与一线少年司法人员一起对高危青少年实施短暂的自杀干预

基本信息

批准号：
9350393
负责人：
Kathleen Kemp
金额：
$ 18.22万
依托单位：
RHODE ISLAND HOSPITAL
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：
2016-09-09 至 2020-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9350393
关键词：
Accident and Emergency department Address Administrator Adolescent Age Appointment Behavioral Caregivers Caring Cause of Death Clinical Clinical Research Communities Community Practice Community of Practice Coordination and Collaboration Data Effectiveness Effectiveness of Interventions Emergency Situation Emergency medical service Evaluation Event Evidence based intervention Family Feeling suicidal Future General Population Goals Health Health system Healthy People 2020 Home environment Hospitalization Individual Intervention Interview Investigational Therapies Justice Knowledge Literature Mental Health Mental Health Services Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methods Modeling Morbidity - disease rate Motivation National Institute of Mental Health Outpatients Partnership Practice Phase Prevalence Process Protocols documentation Public Health Randomized Recruitment Activity Research Research Methodology Research Project Grants Research Training Risk Factors Role Safety Self-Injurious Behavior Services Strategic Planning Suicide Suicide attempt Suicide prevention System Techniques Testing Time Training Trauma Underserved Population United States Universities Work Youth base behavioral health brief intervention cohort community setting cost court design efficacy trial evidence base experience high risk high risk population improved innovation juvenile justice system learning strategy medical schools novel peer post intervention programs reducing suicide research study routine care screening screening and brief intervention skills standard of care suicidal suicidal adolescent suicidal behavior suicidal risk treatment trial uptake

项目摘要

Project Summary/Abstract Suicide and suicidal behaviors among youth in the United States represents a significant public health problem. Youth involved in the juvenile justice system have a greater burden of risk factors associated with suicide ideation and behaviors as compared to their non-justice involved peers, placing these youth at greater risk for suicide. Thus, the overall goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to support the applicant in developing the skills to launch an independent research program focused on the dissemination and implementation of evidence-based interventions for court-involved non-incarcerated (CINI) youth involved in the juvenile justice system to reduce psychiatric morbidity. Specific training goals are: (1) engage in intensive clinical and research training to increase my expertise in conducting brief interventions for adolescent suicide, (2) develop expertise in dissemination and implementation strategies and research in the juvenile justice system, (3) achieve skills in mixed-method research methodology including design and analysis of studies to support causal inference when randomization is not possible. The applicant will pursue these goals through a combination of mentoring, didactics, and practical experience. Specific training goals for this 5-year-period will be achieved under the mentorship of Drs. Anthony Spirito (Brown University), Marina Tolou-Shams (UCSF), Gina Vincent (UMASS Medical School), and Peter Friedmann (Baystate Health). The objective of the proposed research study is to 1) identify individual-, administrative-, and system-level factors that promote or hinder uptake of a brief suicide intervention conducted by front-line juvenile justice staff with CINI youth and 2) implement an evidence-based brief intervention, safety planning, for suicidal CINI youth and evaluate its utility with these youth. In the Treatment Adaptation phase, 12 juvenile justice stakeholders will be interviewed pre- and post-intervention implementation, as well as 24 youth and 24 caregivers 3-months post- intervention, about the acceptability of the brief intervention in the juvenile court setting. In the Treatment Trial phase, we will examine the effectiveness of a safety planning intervention for indicated suicidal youth in reducing suicidal ideation, in reducing suicidal events (suicide attempts as well as emergency evaluations and psychiatric hospitalizations for suicidality), increased engagement in outpatient mental health treatment, and improved youth motivation for treatment. CINI juveniles, ages 12-17, (N=100 for baseline (historical control) cohort; N=100 for efficacy trial; N=100 for alternative causal design) and a caregiver will be recruited from the juvenile court to participate in the current study. CINI juveniles in the efficacy trial will receive the evidenced- based brief suicide intervention as part of standard of care and will be compared to historical control and alternative causal design. Baseline data will be collected as part of routine care. Youth and a caregiver will be re-assessed at 3 months subsequent to the juvenile's initial court appointment.

项目概要/摘要美国青少年的自杀和自杀行为代表着重要的公共卫生问题问题。参与少年司法系统的青少年面临更大的风险因素负担与非司法参与的同龄人相比，这些年轻人的自杀意念和行为更加严重自杀的风险。因此，本次以患者为导向的研究职业发展奖的总体目标 (K23) 是为了支持申请人发展启动独立研究项目的技能关于向法院参与的非监禁人员传播和实施基于证据的干预措施 (CINI) 青少年参与少年司法系统以减少精神疾病发病率。具体训练目标是： (1) 参加密集的临床和研究培训，以提高我进行简短干预的专业知识对于青少年自杀，(2) 发展传播和实施策略以及研究方面的专业知识少年司法系统，(3) 获得混合方法研究方法的技能，包括设计和当随机化不可能时，对研究进行分析以支持因果推断。申请人将追求通过指导、教学和实践经验的结合来实现这些目标。具体训练目标这5年的时间将在博士的指导下实现。安东尼·斯皮里托（布朗大学），玛丽娜 Tolou-Shams（加州大学旧金山分校）、Gina Vincent（麻省大学医学院）和 Peter Friedmann（Baystate Health）。这拟议研究的目标是 1) 确定个人、管理和系统层面的因素促进或阻碍一线少年司法工作人员进行简短的自杀干预 CINI 青少年和 2) 对有自杀倾向的 CINI 青少年和实施基于证据的简短干预、安全规划评估它对这些年轻人的效用。在治疗适应阶段，12 个少年司法利益攸关方将采访了干预前后的实施情况，以及干预后 3 个月的 24 名青少年和 24 名护理人员干预，关于在少年法庭环境中进行短暂干预的可接受性。在治疗试验中阶段，我们将检查针对有自杀倾向的青少年的安全规划干预措施的有效性减少自杀意念，减少自杀事件（自杀企图以及紧急评估和因自杀而住院治疗），增加门诊心理健康治疗的参与度，以及提高青少年的治疗积极性。 CINI 青少年，12-17 岁（基线 N=100（历史对照）队列；功效试验N=100；对于替代因果设计，N = 100）并且将从中招募一名护理人员少年法庭参与目前的研究。功效试验中的 CINI 青少年将获得已证实的- 基于简短的自杀干预作为护理标准的一部分，并将与历史控制和另类因果设计。基线数据将作为日常护理的一部分进行收集。青少年和照顾者将青少年首次出庭后 3 个月后重新评估。