Suicide Prevention for Sexual and Gender Minority Youth

性和性别少数青少年的自杀预防

基本信息

批准号：
10495473
负责人：
Aaron J Blashill
金额：
$ 74.31万
依托单位：
SAN DIEGO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-09 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10495473
关键词：
Adolescent Age Birth Cause of Death Clinical Communities Coping Skills Data Disparity Family Friends Future Gender General Population Grant Health Resources Heterosexuals Individual Intervention Lesbian Gay Bisexual Literature Longitudinal Studies Mental Health Meta-Analysis Methods Motivation Participant Persons Phase Population Preparation Prevalence Prevention program Problem Solving Public Health Randomized Randomized, Controlled Trials Recording of previous events Reporting Research Resources Safety Sampling Services Sexual and Gender Minorities Sexual and Gender Minority Youth Social support Suicide Suicide attempt Suicide prevention Support Groups Testing Vulnerable Populations Youth acceptability and feasibility cisgender comparison intervention completed suicide cost design efficacy trial emerging adult experience feasibility testing gender minority health disparity high risk innovation intervention participants intervention program longitudinal analysis nonbinary patient navigation patient navigator pilot test pilot trial population based preventive intervention programs psychologic reducing suicide sex sexual minority sexual minority youth suicidal suicidal morbidity therapy design transgender trend

项目摘要

PROJECT SUMMARY Suicide is the 10th leading cause of death among all U.S. citizens and is the 2nd leading cause of death among youth and emerging adults between the ages of 15 and 29. One group that is particularly vulnerable to suicide is sexual and gender minorities (SGMs). SGM is an umbrella term used to describe individuals who identify as non-exclusively heterosexual (e.g., gay, lesbian, bisexual) and/or as transgender/non-binary (e.g., identify as a gender different from their birth sex). Indeed, recent U.S. representative findings from 2017 underscore striking disparities in suicidality between sexual minority and heterosexual adolescents, with 23% of sexual minority youth reporting one or more suicide attempts (in the past 12 months) vs. 5.4% of heterosexual youth. Prevalence of lifetime suicide attempts among gender minorities is also substantially elevated compared to the general population, with 45% of 18-24-year-old transgender individuals reporting a history of one more suicide attempts. Despite these substantial health disparities in suicide among SGM youth/emerging adults, no known suicide prevention programs exist for this highly vulnerable population. Given this crucial gap in the literature, the proposed study will adapt and test an innovative intervention that integrates patient navigation with the Safety Planning Intervention (PN+SPI) for SGM youth/emerging adults designed to target mechanisms (e.g., reductions in thwarted belongingness and increases in suicide-related coping skills) that theoretically underlie suicide. If the PN+SPI intervention displays a clinically meaningful effect on the purported targets (i.e., reductions in thwarted belongingness and increases in suicide-related coping skills) during the open-phase trial (R61 phase) and is feasible and acceptable, we will subsequently move to the R33 phase. In the R33 phase, we will conduct a pilot randomized controlled trial of the PN+SPI by comparing it to SPI alone to assess feasibility, acceptability, and preliminary efficacy. During the randomized controlled trial, in which we will sample 170 youth and emerging adult SGMs, we will also evaluate the mechanisms of action of the PN+SPI intervention through longitudinal analysis. The proposed project has substantial public health significance as SGMs are one of the most vulnerable groups for suicidality globally. Given the brevity of the PN+SPI intervention and its emphasis on safety planning and accessing community resources, the PN+SPI intervention has high potential for wide dissemination and public health impact.

项目概要自杀是所有美国公民的第十大死因，也是美国公民的第二大死因 15 至 29 岁的青少年和新兴成年人。特别容易自杀的一个群体是性少数群体（SGM）。 SGM 是一个总称，用于描述那些认为自己是非纯粹的异性恋（例如男同性恋、女同性恋、双性恋）和/或跨性别者/非二元性别（例如，认同为性别不同于出生性别）。事实上，2017 年美国最近的代表性调查结果凸显了惊人的性少数青少年和异性恋青少年的自杀倾向存在差异，其中性少数青少年自杀倾向为 23% 报告一次或多次自杀未遂的青少年（在过去 12 个月内）与 5.4% 的异性恋青少年相比。患病率与一般人群相比，少数性别群体终生自杀未遂的比例也大幅升高人口中，45% 的 18-24 岁跨性别者报告有过一次自杀未遂的历史。尽管SGM青少年/新兴成年人的自杀健康状况存在巨大差异，但尚无已知的自杀事件针对这一高度弱势群体制定了预防计划。鉴于文献中的这一关键空白，拟议的研究将调整和测试一种创新的干预措施，将患者导航与安全性相结合针对SGM青少年/新兴成年人的规划干预（PN+SPI），旨在针对目标机制（例如减少归属感受挫以及与自杀相关的应对技巧的增加）理论上是自杀的原因。如果 PN+SPI 干预对声称的目标显示出具有临床意义的效果（即减少受阻的开放阶段试验（R61 阶段）期间的归属感和自杀相关应对技能的增加）可行且可接受，我们随后将进入R33阶段。在R33阶段，我们将进行试点 PN+SPI 的随机对照试验，通过将其与单独的 SPI 进行比较来评估可行性、可接受性和初步疗效。在随机对照试验中，我们将对 170 名青少年和新兴人群进行抽样调查成人 SGM 中，我们还将通过纵向评估 PN+SPI 干预的作用机制分析。拟议项目具有重大公共卫生意义，因为 SGM 是最脆弱的群体之一全球范围内的自杀团体。鉴于 PN+SPI 干预的简短性及其对安全规划的重视 PN+SPI 干预措施具有广泛传播和获取社区资源的巨大潜力公共卫生影响。