Adaptation and Pilot Test of a Universal School-Based Suicide Prevention Program

普遍的基于学校的自杀预防计划的适应和试点测试

• 批准号: 10116490
• 负责人: Holly C Wilcox
• 金额: $ 39.28万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-01 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10116490
• 关键词: 13 year old; 16 year old; Accident and Emergency department; Acute; Address; Adolescent; Adolescent Risk Behavior; African American; African American student; Age; Awareness; Baltimore; Cause of Death; Centers for Disease Control and Prevention (U.S.); Child; Cities; Clinical Trials; Communities; Coping Skills; Country; Data; Depressed mood; Depression and Suicide; Development; Educational Curriculum; Epidemiological trend; Europe; European; European Union; Evidence based intervention; Evidence based program; Eye; Feeling suicidal; Female; Future; Grant; Health; Health education; Heterogeneity; High School Student; Incidence; Inpatients; International; Intervention; Knowledge; Leadership; Maryland; Mental Health; Mental health promotion; Methods; Middle School Student; Mind; National Institute of Mental Health; Outcome; Participant; Persons; Pilot Projects; Population; Prevention; Prevention program; Problem Solving; Public Health; Randomized; Registries; Reporting; Research Design; Risk Factors; Safety; School-Age Population; Schools; Services; Strategic Planning; Students; Suicide; Suicide attempt; Suicide prevention; Surveys; System; Testing; Time; Training Programs; United States; Urban Population; Visit; Waiting Lists; Youth; acceptability and feasibility; age group; aged; base; boys; coping; critical period; design; disability; early adolescence; effectiveness evaluation; effectiveness trial; eighth grade; evidence base; flexibility; girls; health disparity; health literacy; health training; high risk; high school; instructor; intervention effect; junior high school; modifiable risk; mood symptom; personalized intervention; pilot trial; prevent; primary outcome; programs; racial disparity; racial diversity; randomized trial; recruit; response; screening; seventh grade; skills; stressor; suicidal behavior; suicidal morbidity; suicidal risk; suicide rate; teacher; uptake

The Centers for Disease Control and Prevention reported that the suicide rate for females aged 10 –14 has had the largest percent increase (200%) of any other demographic group between 1999 and 2014, tripling from 0.5 per 100,000 in 1999 to 1.5 in 2014. Although the rates of suicide are relatively rare in these ages, as compared to older ages, the sharp increase in suicide among young people is alarming. Data from the 2016 Youth Risk Behavior Surveillance System showed that 27% of Baltimore City middle school students (ages 11- 14) reported having ever thought about killing themselves and 14% had ever attempted suicide. With suicide being the second leading cause of death for persons ages 10-14, it is important to target prevention efforts early. Almost all of the existing suicide prevention programs target suicide risk in high school, which is too late to meet the needs of middle school students. The primary aim of this R34 pilot effectiveness trial is to establish the feasibility, acceptability, preliminary impact, and potential for future uptake of the Youth Aware of Mental Health (YAM) program. YAM is an evidence-based mental health promotion program administered in schools that has been shown to be effective among primarily white European high school students ages 14 to 16 years old. In a large randomized trial involving 11,110 students from 168 schools in ten European Union countries, students randomized to YAM reported 55% lower incidence of suicide attempts and 50% lower incidence of severe suicidal ideation over one year. YAM was chosen for the proposed study not just because of these outcome data, but because it aligns with U.S. National Health Education Standards, and because it was created with the heterogeneity of youth in mind. Our adaptation and implementation of YAM will include five sessions delivered in middle school health education class by trained health education teachers. Given its flexibility, YAM was designed with an eye toward community implementation, sustainment and scalability. YAM’s proposed target mechanisms of action involve enhancing problem-solving and coping skills to manage acute stressors. This pilot study will examine feasibility and acceptability of the proposed recruitment methods, research design, intervention, assessment methods and training program in a school system with a majority African American population by matching 7th and 8th grade classrooms by school and randomizing classrooms to YAM or to the wait-list control condition. The primary outcomes will be suicidal ideation and mood symptoms in the 3 months after YAM implementation. This proposed pilot effectiveness trial will lay the groundwork for a larger clinical trial (R01) to evaluate the effectiveness of YAM on suicidal behaviors in urban middle school students.

美国疾病控制与预防中心报告称，10-14岁女性的自杀率 1999 年至 2014 年间，该群体的百分比增幅最大（200%），是 1999 年至 2014 年间的三倍 1999 年每 10 万人中有 0.5 人自杀，到 2014 年为每 10 万人 1.5 人。尽管自杀率在这些年龄段相对较少，但 与老年人相比，2016年的数据显示，年轻人的自杀率急剧上升，令人震惊。 青少年危险行为监测系统显示，27% 的巴尔的摩市中学生（11 岁至 14) 据报道曾想过自杀，14% 的人曾试图自杀。 作为 10 至 14 岁人群的第二大死因，有针对性的预防工作非常重要 几乎所有现有的自杀预防计划都针对高中的自杀风险，但为时已晚。 满足中学生的需求 本次 R34 试点有效性试验的主要目的是建立 青年心理意识的可行性、可接受性、初步影响和未来采用的潜力 健康 (YAM) 计划是一项在学校实施的循证心理健康促进计划。 这已被证明对 14 至 16 岁的欧洲白人高中生有效 在一项涉及来自 10 个欧盟国家 168 所学校的 11,110 名学生的大型随机试验中， 随机参加 YAM 的学生报告自杀未遂发生率降低 55%，自杀未遂发生率降低 50% 选择 YAM 进行拟议研究不仅仅是因为这些。 结果数据，但因为它符合美国国家健康教育标准，并且因为它是 我们的 YAM 调整和实施将包括五个方面。 由经过培训的健康教育教师在中学健康教育课上授课。 灵活性，YAM 的设计着眼于社区实施、可持续性和可扩展性。 YAM 提议的目标行动机制涉及增强解决问题和应对管理的技能 这项试点研究将检查拟议招募方法的可行性和可接受性， 学校系统中的研究设计、干预、评估方法和培训计划 通过按学校匹配 7 年级和 8 年级教室并随机化教室来了解非裔美国人人口 YAM 或等待名单控制条件的主要结果将是自杀意念和情绪症状。 在 YAM 实施后的 3 个月内，拟议的试点有效性试验将为后续实施奠定基础。 评估YAM对城市中学自杀行为有效性的大型临床试验（R01） 学生。