Stepped care for suicide prevention in teens and young adults: Design and methods of a randomized controlled trial.
Stepped care for suicide prevention in teens and young adults: Design and methods of a randomized controlled trial.
复制标题
青少年和年轻人自杀预防的分级护理：随机对照试验的设计和方法。
DOI：
10.1016/j.cct.2022.106959
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发表时间：
2022
影响因子：
2.2
通讯作者：
Asarnow,JoanR
中科院分区：
文献类型：
--
作者：
Sheppler,ChristinaR;Edelmann,AnnaC;Firemark,AlisonJ;Sugar,CatherineA;Lynch,FrancesL;Dickerson,JohnF;Miranda,JeanneM;Clarke,GregoryN;Asarnow,JoanR
背景：自杀是美国青少年和年轻人死亡的第二大原因，在过去十年的大部分时间里，自杀率都在上升。设计、测试和实施预防这一人群自杀的干预措施是一项公共卫生重点。这份手稿概述了一项研究的设计和方法，比较了两种旨在减少青少年自杀和自杀企图的干预措施。方法选择300名年龄在12-24岁的自杀高危青少年进行随机对照平行组优势试验。参与者将被随机分配到两个研究组中的一个：(1)在Kaiser Permanente Northwest （KPNW）卫生系统内实施的零自杀质量改善（ZSQI），或(2)ZSQI加自杀预防的阶梯护理干预（SC-SP），其中提供的服务（包括护理管理和辩证行为治疗[DBT]）根据风险水平增加。结果将在基线以及随机化后3、6和12个月进行评估。该研究是由加州大学洛杉矶分校和KPNW的研究人员共同构思和设计的。结果待在以后的文章中报道。结论本研究的主要目的是确定SC-SP干预在降低致死性和非致死性自杀企图率方面是否优于ZSQI。纳入最新研究的干预措施需要在受控条件下进行设计和测试，以朝着实现零自杀的目标取得进展。这项试验的结果将直接影响这些努力。临床试验注册。clinicaltrials.gov, NCT03092271, https://clinicaltrials.gov/ct2/show/NCT03092271https://clinicaltrials.gov/ct2/show/NCT01379027。
BackgroundSuicide is the second‑leading cause of death among adolescents and young adults in the United States, with rates rising over much of the last decade. The design, testing, and implementation of interventions to prevent suicide in this population is a public health priority. This manuscript outlines the design and methods for a research study that compares two interventions aimed at reducing suicide and suicide attempts in youth.MethodsWe will enroll 300 youth aged 12–24 at high risk for suicide in this randomized controlled parallel group superiority trial. Participants will be randomly assigned to one of two study arms: (1) Zero Suicide Quality Improvement (ZSQI) implemented within the Kaiser Permanente Northwest (KPNW) health system, or (2) ZSQI plus a stepped care intervention for suicide prevention (SC-SP), where the services offered (including care management and dialectical behavior therapy [DBT]) increase based on risk level. Outcomes will be assessed at baseline, as well as 3-, 6-, and 12-months post randomization. The study was conceptualized and designed collaboratively by investigators at UCLA and KPNW.ResultsTo be reported in future manuscripts.ConclusionThe main objective of the study is to determine whether the SC-SP intervention is superior to ZSQI with regard to lowering rates of fatal and nonfatal suicide attempts. Interventions that incorporate the latest research need to be designed and tested under controlled conditions to make progress toward the goal of achieving zero suicide. The results from this trial will directly inform those efforts.Trial Registration.clinicaltrials.gov, NCT03092271, https://clinicaltrials.gov/ct2/show/NCT03092271https://clinicaltrials.gov/ct2/show/NCT01379027.