SAFETY-A for Promoting Equity in Suicide Prevention Outcomes in Schools

SAFETY-A 促进学校自杀预防成果的公平

基本信息

批准号：
10864071
负责人：
ANNA Shan-Lai LAU
金额：
$ 7.9万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10864071
关键词：
Accident and Emergency department Acute Address Administrator Adolescent Age American Asian Americans Caregivers Caring Case Series Characteristics Clinical Cluster randomized trial Coercion Cognitive Therapy Collaborations Communication Continuity of Patient Care Data Death Rate Detection Disparity Distress Emergency department visit Emotions Equity Ethnic Population Family Feedback Feeling suicidal Funding Hospitalization Hybrids Intervention Investigation Latina Latinx Low income Mental Health Mental Health Services Methods Not Hispanic or Latino Outcome Parents Perception Persons Phase Policies Prevention Protocols documentation Provider Randomized Reporting Research Resource-limited setting Resources Risk Risk Assessment Schools Structure Students Suicide attempt Suicide prevention Symptoms Teenagers Testing Time Training Trust United States National Institutes of Health Youth acceptability and feasibility design disparity reduction effectiveness/implementation trial emotional distress ethnic disparity ethnic minority ethnic minority population evidence base follow-up health service use human centered design hybrid type 1 trial implementation barriers implementation evaluation implementation outcomes implementation science implementation strategy improved internalized stigma medical specialties minority children minority student peer pilot trial primary outcome prototype provider adherence racial disparity racial minority population racial population randomized trial response school district secondary outcome service providers skills training social stigma suicidal suicidal adolescent suicidal behavior suicidal morbidity suicidal risk therapy development workforce needs

项目摘要

PROJECT SUMMARY Ethnic minority adolescents, including Asian American and Latinx adolescents are at increased risk for suicidal thoughts and attempts compared to their Non-Hispanic White (NHW) peers, yet they are less likely to receive mental health services (MHS) after their suicide risk is identified. Although school-based MHS reduce access barriers, racial disparities persist within suicide prevention efforts in schools. The proposed study will adapt Safe Alternatives For Teens and Youth – Acute (SAFETY-A) for implementation in low-resourced school districts to target putative mechanisms underlying disparities in MHS use following youth suicide risk detection. SAFETY-A will be adapted to reduce mistrust of MHS, internalized stigma, and concealment of youth emotional distress that drive poor engagement in MHS among Asian American and Latinx students and families. Furthermore, SAFETY-A delivery parameters and implementation strategies will be adapted to fit the organizational context of school district policies and protocols, resource constraints, and workforce needs. The proposed intervention development study will include three phases. First, stakeholders will be engaged to design adaptations to the intervention and implementation strategy. Provider, youth and caregiver input will be gathered using human-centered design approaches to adapting the SAFETY-A intervention content to address disparities mechanisms. School district leaders, school administrators, and MHS providers will help to develop a tailored implementation strategy to fit local training and support needs across a range of district contexts. Second, a prototyping case series will inform iterative refinements of SAFETY-A in one school district. Third, a pilot controlled trial will randomize school districts to the timing of implementation to provide preliminary data on the impact of SAFETY-A on proposed mechanisms of action (trust in MHS, stigma, youth emotion communication) and the primary outcome of MHS utilization and the secondary outcome of suicidal thoughts and behaviors across racial/ethnic groups. Mixed methods will be used to assess implementation outcomes of provider adherence, and perceptions of feasibility, acceptability and fit. The proposed project will provide preliminary data on feasibility and potential impacts on putative mechanisms to propose a definitive Hybrid Type 1 trial to test SAFETY-A as an intervention to reduce racial/ethnic disparities in MHS utilization among suicidal youth.

项目概要少数族裔青少年，包括亚裔美国人和拉丁裔青少年，患此病的风险更高与非西班牙裔白人 (NHW) 同龄人相比，他们有自杀念头和尝试，但自杀的可能性较小在确定自杀风险后接受心理健康服务 (MHS)，尽管以学校为基础的心理健康服务会降低。拟议的研究将在学校预防自杀工作中持续存在种族差异。调整青少年和青少年的安全替代方案 - 急性 (SAFETY-A)，以便在资源匮乏的学校实施各地区针对青少年自杀风险检测后 MHS 使用差异的推定机制。 SAFETY-A 将进行调整，以减少对 MHS 的不信任、内在的耻辱和对青少年的隐瞒情绪困扰导致亚裔美国人和拉丁裔学生对 MHS 的参与度较差，此外，SAFETY-A 交付参数和实施策略将进行调整以适应家庭。学区政策和协议、资源限制和劳动力需求的组织背景。拟议的干预开发研究将包括三个阶段：首先，利益相关者将参与其中。设计对干预和实施策略的调整。提供者、青少年和护理人员的意见将。使用以人为本的设计方法来收集，以适应 SAFETY-A 干预内容解决差异的机制。学区领导、学校管理人员和 MHS 提供者将帮助制定量身定制的战略，以满足各个地区的当地培训和支持需求其次，原型案例系列将为一所学校的 SAFETY-A 的迭代改进提供信息。第三，试点对照试验将随机分配学区以提供实施时间。关于 SAFETY-A 对拟议行动机制影响的初步数据（对 MHS 的信任、耻辱、青年情绪沟通）以及 MHS 使用的主要结果和自杀的次要结果将使用混合方法来评估实施情况。提供者遵守的结果，以及对拟议项目的可行性、可接受性和适合性的看法。提供有关可行性和对假定机制的潜在影响的初步数据，以提出明确的建议混合 1 型试验，测试 SAFETY-A 作为减少 MHS 使用方面种族/民族差异的干预措施在有自杀倾向的青少年中。

项目成果

期刊论文数量（1）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Leader and Provider Perspectives on Implementing Safe Alternatives for Teens and Youth - Acute (SAFETY-A) in Public School Districts Serving Racial/ethnic Minoritized Youth.

领导者和提供者对在公立学区为少数族裔青年提供青少年和青年安全替代方案（SAFETY-A）的看法。

DOI：
发表时间：
2023-06
期刊：
影响因子：
2.6
作者：
Yu, Stephanie H;Kodish, Tamar;Bear, Laurel;O'Neill, J Conor;Asarnow, Joan R;Goldston, David;Cheng, Karli K;Wang, Xinran;Vargas, Sylvanna M;Lau, Anna S
通讯作者：
Lau, Anna S