Lumbee Rite of Passage: A Suicide Prevention Model for American Indian Youth

Lumbee 成年仪式：美国印第安青年的自杀预防模式

• 批准号: 8105509
• 负责人: Ronny A Bell
• 金额: $ 18.32万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-05 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8105509
• 关键词: Acculturation; Adolescent; Affect; African American; Age; American; American Indians; Communities; Country; County; Dancing; Data; Ethnic group; Feasibility Studies; Feedback; Feeling hopeless; Feeling suicidal; Focus Groups; Gatekeeping; Gender; Goals; Health; Health Resources; Hearing; Home environment; Individual; Intervention; Interview; Knowledge; Lead; Life; Lumbee tribe; Measures; Mental Health; Mental disorders; Mississippi; Modeling; North Carolina; Obesity; Outcome; Participant; Perception; Population; Poverty; Preventive Intervention; Public Health; Randomized; Recording of previous events; Research; Research Personnel; Reservations; Risk Factors; Rivers; Running; Rural; Services; Sex Orientation; Social support; Study models; Substance abuse problem; Suicide; Suicide attempt; Suicide prevention; Surveys; Testing; Tribes; United States; Universities; Ursidae Family; Youth; accomplished suicide; aged; base; boys; comparison group; depressive symptoms; experience; forest; girls; health equity; impression; improved; innovation; medical schools; member; post intervention; programs; public health relevance; self esteem; suicidal behavior; suicidal risk; suicide rate

DESCRIPTION (provided by applicant): Suicide is a threat to the health of all Americans, but some ethnic groups are more affected than others. Limited data indicate that American Indian (AI) youth experience high rates of suicide completions, suicide attempts, and suicidal ideation compared to their non-Latino white counterparts. Many factors contribute to suicidal ideation in AI youth, including depressive symptoms, low self-esteem, substance abuse, hopelessness, forced acculturation, and lack of social support. Cultural interventions (interventions that utilize cultural practices to intervene on health outcomes, as distinguished from interventions that are merely culturally appropriate) have recently been associated with positive health outcomes in AIs as well as other ethnic groups. Still, while it is highly recommended that interventions targeting mental illness in AI youth consider cultural constructs related to health, very few studies have used this approach to-date. North Carolina (NC) is home to the largest AI population east of the Mississippi River. The Lumbee Indian tribe, a non- reservation tribe with a population of about 50,000, is the largest tribe in the state and is largely concentrated in Robeson County. The overall goal of the proposed exploratory study, Lumbee Rite of Passage for Life, is to determine the impact of cultural programs, specifically a culture class conducted by the Lumbee tribe at three tribally owned Boys and Girls Clubs, on suicide ideation in American Indian adolescents between the ages of 12 and 17 years. The study will entail participation from the Lumbee community and will be conducted as a partnership between the Maya Angelou Center for Health Equity (MACHE) at Wake Forest University School of Medicine (WFUSM), the University of NC at Pembroke (UNCP), and the Lumbee Tribe of NC. This exploratory R21 will accomplish two specific aims: (1) to assess perceptions regarding suicidal behavior and risk factors for suicide and examine mental health needs among and services for Lumbee Indian youth (ages 12-17 years) in Robeson County, NC; and (2) to determine the impact of a tribally-run cultural program on suicidal ideation and its risk factors. A secondary aim to Specific Aim 2 is to examine the moderating effects of demographic variables (including gender), sexual orientation, and obesity on the relationship between participation in the culture classes and suicidal ideation. For Aim 1, we plan in-depth interviews with community gatekeepers regarding availability and quality of mental health resources and focus groups with Lumbee youth to identify impressions of mental health issues, particularly regarding suicide and its risk factors in their community. For Aim 2, investigators will conduct a feasibility study in conjunction with the Lumbee tribe to measure changes in suicidal ideation and its risk factors that occur as a result of participation in a cultural program that includes native dancing, pow-wow singing, NC Indian history, beading, and pottery. Participants will be randomized into intervention and delayed intervention (comparison) groups, and pre- and post-intervention measures of suicide ideation and factors associated with it will be collected via surveys. PUBLIC HEALTH RELEVANCE: Suicide and its risk factors remain a major public health concern in the United States, and American Indians bear an unequal burden of completed suicides, suicide attempts, and suicidal ideation compared to whites. The proposed exploratory study is a partnership with the Lumbee Indian tribe of North Carolina and will test the feasibility of using a tribally run culture class to promote positive mental health outcomes and reduce suicidal behaviors among Lumbee adolescents. While we acknowledge that culture may only be one of many things that promote good mental health among young people, innovative research such as this could lead to more comprehensive treatment and prevention interventions and therefore add to the body of public health knowledge.

描述（由申请人提供）：自杀是对所有美国人健康的威胁，但有些种族比其他族裔更受影响。有限的数据表明，与非拉丁裔白人白人相比，美洲印第安人（AI）青年人的自杀完成率很高，自杀企图和自杀念头。许多因素有助于AI青年的自杀念头，包括抑郁症状，自尊心低，药物滥用，绝望，强迫培养和缺乏社会支持。文化干预措施（利用文化实践来干预健康结果的干预措施，与仅在文化上适当的干预措施区别）最近与AIS和其他种族的积极健康成果有关。尽管如此，尽管强烈建议针对AI青年的精神疾病的干预措施考虑与健康有关的文化结构，但很少有研究使用这种方法。北卡罗来纳州（NC）是密西西比河以东最大的AI人口的所在地。 Lumbee印度部落是一个人口约50,000的非保留部落，是该州最大的部落，主要集中在Robeson县。拟议的探索性研究的总体目标，即终身通道的腰部仪式，是确定文化计划的影响，特别是由伦贝部落在三个部落拥有的男孩和女孩俱乐部进行的文化阶级，对12至17岁之间的美洲印度青少年的自杀式观念。这项研究将需要从Lumbee社区参与，并将作为Wake Forest University医学院（WFUSM），北卡罗来纳大学Pembroke（UNCP）的NC（UNCP）和NC Lumbee Tribe的Maya Angelou卫生公平中心（MACH）之间的合作伙伴关系。此探索性R21将实现两个具体的目标：（1）评估自杀自杀行为和危险因素的看法，并检查北卡罗来纳州罗伯森县Lumbee Indian青年（12-17岁）的精神健康需求以及服务的心理健康需求； （2）确定部落经营的文化计划对自杀意念及其风险因素的影响。特定目标2的次要目的是检查人口统计学变量（包括性别），性取向和肥胖对参与文化阶级和自杀念头之间关系的调节作用。对于AIM 1，我们计划与社区守门员有关心理健康资源的可用性和质量以及与Lumbee青年的焦点小组的深入访谈，以确定心理健康问题的印象，尤其是关于自杀及其在社区中的风险因素的印象。对于AIM 2，研究人员将与Lumbee部落一起进行可行性研究，以衡量由于参与包括本地舞蹈，Pow-Wow Singing，NC印度历史，珠饰和陶器的文化计划而发生的自杀念头的变化及其风险因素。参与者将被随机分为干预和延迟干预（比较）组，以及自杀前和自杀后的措施以及与之相关的因素，将通过调查收集。 公共卫生相关性：自杀及其风险因素在美国仍然是一个主要的公共卫生问题，与白人相比，美国印第安人承担着不平等的自杀，自杀企图和自杀念头的负担。拟议的探索性研究是与北卡罗来纳州Lumbee印度部落的合作伙伴关系，将测试使用部落运行的文化阶级来促进积极的心理健康成果并减少肿瘤青少年中的自杀行为的可行性。尽管我们承认文化可能只是促进年轻人良好心理健康的众多因素之一，但诸如此类的创新研究可能会导致更全面的治疗和预防干预措施，因此增加了公共卫生知识的体系。

项目成果

Sleep Problems, Suicidality and Depression among American Indian Youth.

美国印第安青年的睡眠问题、自杀和抑郁。

• DOI: 10.4172/2325-9639.1000119
• 发表时间: 2013
• 期刊: Journal of sleep disorders-- treatment & care
• 作者: Arnold,ElizabethMayfield;McCall,VaughnW;Anderson,Andrea;Bryant,Alfred;Bell,Ronny
• 通讯作者: Bell,Ronny