Implementing School Nursing Strategies to Reduce LGBTI Adolescent Suicide

实施学校护理策略以减少 LGBTI 青少年自杀

基本信息

批准号：
9029127
负责人：
Mary Ramos
金额：
$ 61.38万
依托单位：
PACIFIC INSTITUTE FOR RES AND EVALUATION
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：
2016-05-12 至 2021-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9029127
关键词：
Accounting Address Adolescent Adoption Advocate Alcohol or Other Drugs use Behavior Caring Centers for Disease Control and Prevention (U.S.)Child health care Childhood Collaborations Communities Community Health Depression and Suicide Disadvantaged Discrimination Educational Curriculum Environment Evaluation Evaluation Research Evidence based intervention Evidence based practice Feedback Focus Groups Health Health Educators Health Personnel Health Services Health education Healthcare Heterosexuals High School Student Improve Access Individual Institute of Medicine (U.S.)Intervention Intervention Studies Interview Knowledge Lead Leadership Lesbian Gay Bisexual Lesbian Gay Bisexual Transgender Intersex Mental Depression Mental Health Methodology Methods Minority Modeling Monitor NIH Program Announcements New Mexico Nurse&apos s Role Nurses Nursing Process Nursing Schools Outcome Policies Population Positioning Attribute Preparation Preventive Process Process Assessment Professional counselor Psyche structure Public Health Qualitative Methods Randomized Controlled Trials Reporting Research Research Infrastructure Research Institute Resources Risk Role Safety School Health Services School Nursing Schools Sexual and Gender Minorities Social Workers Staff Development Stress Structure Students Suicide Surveys System Training Training and Education Underserved Population United States National Institutes of Health Universities Violence Vulnerable Populations Work Youth adolescent health base bullying cisgender disorder prevention evidence base experience high school implementation science improved innovation member minority student model building novel nursing intervention peer population based prevent psychologic public health priorities public health relevance reducing suicide school health sexual minority skills social social stigma suicidal behavior suicidal risk treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Reducing youth suicide in the U.S. is a national public health priority. A supportive and safe school environment is pivotal to preventing youth suicide, and schools are now widely accepted as part of the de facto mental healthcare infrastructure for adolescents. Lesbian, gay, bisexual, transgender, and intersex (LGBTI) youth are at elevated risk for suicide. Safer school environments decrease this risk. The school nurse is well positioned to implement evidence-based (EB) strategies to enhance school environments and improve the mental health of all students, particularly members of this vulnerable population. These strategies include the creation of "safe spaces," adoption of harassment and bullying prohibitions, improved access to community health and mental health providers experienced in working with youth and LGBTI people, school staff development, and incorporation of LGBTI-specific information into health education curricula. These strategies promote positive mental health outcomes for LGBTI youth, and their cisgender, heterosexual peers as well. Our nursing intervention model is called "RLAS" (Implementing School Nursing Strategies to Reduce LGBTI Adolescent Suicide). It builds on the Exploration, Preparation, Implementation, and Sustainment conceptual framework and the Dynamic Adaptation Process (DAP), a structured methodology for implementing the EB strategies. The DAP accounts for the multi-level context of school settings, facilitates appropriate expertise and feedback to make them "implementation ready," and provides for targeted training of school nurses. Per the DAP, the nurses will convene and lead Implementation Resource Teams (IRTs) consisting of counselors, social workers, health educators, and youth. With the guidance of coaches, the IRTs will engage in an iterative process of assessment and planning to build school capacity and implement the EB strategies. To evaluate this model, we combine qualitative methods with population-based surveys and pursue three specific aims. First, we will utilize the DAP to enable specially-trained nurse champions and IRTs to implement and sustain EB strategies to address the needs of LGBTI high school students. Second, we will conduct a cluster randomized controlled trial (RCT) to assess whether sexual minority students and their peers in RLAS schools report reductions in suicidality, depression, substance use, and bullying, and increased safety compared to those in usual care schools. Third, we will examine the individual, school, and community factors influencing both implementation and outcomes. The RLAS keeps with national priorities to: (a) improve school-based services for pediatric populations; (b) focus on LGBTI youth mental health; and (c) revolutionize the role of nurses in U.S. healthcare. Through its collaborative processes to refine, improve, and sustain EB strategies in these systems, the RLAS also represents a novel and innovative contribution to implementation science.

描述（由申请人提供）：在美国，减少青少年自杀是一项国家公共卫生优先事项。支持性且安全的学校环境对于预防青少年自杀至关重要，学校现已被广泛接受为青少年事实上的心理保健基础设施的一部分。女同性恋、男同性恋、双性恋、跨性别者和双性人 (LGBTI) 青少年的自杀风险较高。更安全的学校环境可以降低这种风险。改善所有学生，特别是弱势群体成员的心理健康。这些策略包括创建“安全空间”、禁止骚扰和欺凌行为、改善获得社区健康以及在青少年和 LGBTI 方面经验丰富的心理健康服务提供者的服务。这些策略促进了 LGBTI 青少年及其顺性别、异性恋同龄人的积极心理健康成果，我们的护理干预模式称为“RLAS”（实施学校）。减少 LGBTI 青少年自杀的护理策略）它建立在探索、准备、实施和维持概念框架和动态适应过程 (DAP) 的基础上，动态适应过程是一种用于实施 EB 策略的结构化方法。DAP 考虑了多层次的背景。学校环境，促进适当的专业知识和反馈，使他们“做好实施准备”，并为学校护士提供有针对性的培训根据 DAP，护士将召集和领导实施资源。由辅导员、社会工作者、健康教育工作者和青少年组成的团队 (IRT) 将在教练的指导下参与评估和规划的迭代过程，以建设学校能力并实施 EB 战略。我们将定性方法与基于人群的调查相结合，并追求三个具体目标：首先，我们将利用 DAP 使经过专门培训的护士冠军和 IRT 能够实施和维持 EB 战略，以满足 LGBTI 高中生的需求。将进行一项整群随机对照试验 (RCT)，旨在评估 RLAS 学校中的性少数学生及其同龄人是否报告自杀倾向、抑郁、药物滥用和欺凌现象有所减少，以及与普通护理学校的学生相比，安全性是否有所提高。 RLAS 与影响实施和结果的个人、学校和社区因素保持一致，以：(a) 改善针对儿科人群的学校服务；(b) 关注 LGBTI 青少年心理健康；(c) 彻底改变这一角色；的护士美国医疗保健。通过其协作流程来完善、改进和维持这些系统中的 EB 策略，RLAS 也代表了对实施科学的新颖和创新贡献。