Community mobilization for rural suicide prevention: Process, learning and behavioral outcomes from Promoting Community Conversations About Research to End Suicide (PC CARES) in Northwest Alaska
Community mobilization for rural suicide prevention: Process, learning and behavioral outcomes from Promoting Community Conversations About Research to End Suicide (PC CARES) in Northwest Alaska
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DOI：
10.1016/j.socscimed.2019.05.028
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发表时间：
2019-07-01
影响因子：
5.4
通讯作者：
Dombrowski, Kirk
中科院分区：
文献类型：
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作者：
Wexler, Lisa;Rataj, Suzanne;Dombrowski, Kirk
基本原理：这项研究评估了促进社区对话关于研究结束自杀（PC CARES）的过程和初步成果，这是一项将关键利益相关者聚集在一起的干预措施，使他们能够讨论自杀预防研究并找到将其付诸实践的方法。该方法最初在阿拉斯加偏远农村社区进行试点，显示出了希望。本研究采用多方法设计，描述了一系列15个月以来由当地提供便利的“学习圈”及其初步结果。记录参与情况的签到表。录音会话的transient捕获主持人的保真度，准确性和社区讨论的主导主题。关联参与者调查（n = 83）比较了与会者的感知知识，技能，态度，和他们的“实践社区”在基线和后续行动。采用横断面设计，比较了112名参与者和335名非参与者在知识和预防行为方面的得分，并考虑了社会网络分析的社会影响。为了证明在小型农村社区的可行性，当地的PC CARES促进者举办了59个两到三个小时的学习圈，有535名参与者（376人）。当地协调员对模型的保真度达到了可接受的水平（80%），并在81%的时间内准确地解释了研究。讨论反映了参与者对研究内容的理解及其在生活中的用途。从基线到后续行动，参与者在感知的知识、技能和态度方面表现出积极的变化，并加强了他们的“实践社区”。社会网络分析表明，PC CARES具有社会影响力，维持和加强了“接近”参与者的非参与者的预防活动。在干预后，这些亲密的同事比其他非参与者更有可能采取预防措施。结论：PC CARES提供了一个实用的，可扩展的方法，以社区为基础的研究证据转化为自我决定的，文化上敏感的自杀预防实践。
Rationale: This study evaluates the process and preliminary outcomes of Promoting Community Conversations About Research to End Suicide (PC CARES), an intervention that brings key stakeholders together so they can discuss suicide prevention research and find ways to put it into practice. Originally piloted in remote and rural Alaskan communities, the approach shows promise.Method.: Using a multi-method design, the study describes a series of locally-facilitated "learning circles" over 15 months and their preliminary results. Sign-in sheets documented participation. Transcriptions of audio-recorded sessions captured facilitator fidelity, accuracy, and the dominant themes of community discussions. Linked participant surveys (n = 83) compared attendees' perceived knowledge, skills, attitudes, and their 'community of practice' at baseline and follow-up. A cross-sectional design compared 112 participants' with 335 non-participants' scores on knowledge and prevention behaviors, and considered the social impact with social network analyses.Results.: Demonstrating feasibility in small rural communities, local PC CARES facilitators hosted 59 two to three hour learning circles with 535 participants (376 unique). Local facilitators achieved acceptable fidelity to the model (80%), and interpreted the research accurately 81% of the time. Discussions reflected participants' understanding of the research content and its use in their lives. Participants showed positive changes in perceived knowledge, skills, and attitudes and strengthened their 'community of practice' from baseline to follow-up. Social network analyses indicate PC CARES had social impact, sustaining and enhancing prevention activities of non-participants who were 'close to' participants. These close associates were more likely take preventive actions than other non-participants after the intervention.Conclusion.: PC CARES offers a practical, scalable method for community-based translation of research evidence into selfdetermined, culturally-responsive suicide prevention practice.