Suicide Prevention Study

自杀预防研究

• 批准号: 10166939
• 负责人: Lisa M. Wexler
• 金额: $ 48.71万
• 依托单位: UNIVERSITY OF ALASKA FAIRBANKS
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10166939
• 关键词: Address; Adult; Age; Alaska; Alaska Native; Arctic Regions; Area; Canada; Cessation of life; Child; Communities; Community Developments; Economics; Education; Effect Modifiers (Epidemiology); Ensure; Epistemology; Family; General Population; Goals; Health; Healthcare; Individual; Informal Social Control; Justice; Knowledge; Life; Measures; Mediating; Methods; Native-Born; Neighborhoods; Ontology; Outcome; Pathway interactions; Pilot Projects; Politics; Prevalence; Prevention; Process; Public Health; Qualitative Methods; Reporting; Research; Resources; Role; Rural; Sampling; Schools; Self Determination; Services; Substance abuse problem; Suicide; Suicide prevention; Testing; Time; Unemployment; Work; Youth; Yukon Kuskokwim; Yukon-Kuskokwim Delta; adverse outcome; alcohol consequences; alcohol misuse; community based participatory research; ideation; indigenous community; member; multilevel analysis; native youth; protective effect; protective factors; reducing suicide; research study; resilience; rural Alaska; rural area; safety net; social; social determinants; sound; suicidal behavior; suicidal risk; suicide rate; tool

The role of social determinants is evident in the disproportionately high rates of Alaska Native (AN) youth suicide that when aggregated across a rural area, can be 18 times higher than the U.S. youth general population for ages 15-19 (124 vs 6.9/ per 100,000). Despite their importance, little is yet known about the community-level resilience and protective processes that rural AN communities enact to protect their youth. Our research seeks to identify the pathways from these larger social and community processes as they individual, youth resilience from suicide, in order to inform a wide variety of prevention efforts with AN youth. The proposed study will use a collaborative mixed methods approach to: (a) identify mutable community-level protective factors that appear to impact youth suicide; (b) test the role of community protective factors and mechanisms, in a multi-level model of youth suicide resilience; and (c) develop and disseminate a practical tool to assess and strengthen community-level protection and reduce suicide risk and increase youth resilience. The Alaska Native Resilience Research Study (ANRRS) has the following specific aims: 1) Assess the association of a set of modifiable cultural, community and institutional factors (protective community factors) with suicide, suicidal behaviors (ideation, attempt), and associated adverse outcomes (accidental death, alcohol-misuse requiring healthcare) in 64 rural and remote Alaska Native villages to identify community-level factors that are most predictive of youth health outcomes; 2) In a stratified random sample of six communities use quantitative methods to test a multi-level model of individual-level youth protective factors, moderated by a set of community-level factors, as predictors of individual-level youth resilience from suicide risk outcomes; and 3) develop and disseminate a method—Alaska Community Resilience Mapping (AK-CRM)—for communities to measure and strategically strengthen these community-level factors to enhance their protective capabilities to increase youth health and reduce the risk for suicide. To conduct the proposed suicide prevention study our team will work with our long-term community research partners in the three Alaska regions with the highest suicide rates: Northwest Arctic, Norton Sound, and Yukon Kuskokwim. As the research progresses, we will share preliminary results with the Alaska Native Collaborative Hub for Resilience Research (ANCHRR) to ensure its relevance throughout Alaska and will disseminate the resulting AK-CRM tool throughout the state. The integration of tribal knowledge and participation in this research will address local needs while maximizing the study’s public health impact. The goal of this work is to identify vital community-level targets that can most effectively contribute to the reduction of youth suicide risk and promote resilience. Our approach will offer a culturally-responsive method for community members to document and bolster their strengths in ways that reflect community priorities, epistemologies, ontologies, and practices, contributing to sustainable solutions for suicide prevention

社会决定者的作用是在阿拉斯加原住民（AN）青年的高度高率中的证据 自杀的自杀，当跨地区汇总时，可能是美国青年将军的18倍 人口15-19岁（124 vs 6.9/每100,000）。尽管它们的重要性，但对 社区级的韧性和保护社区制定以保护青年的过程。 我们的研究旨在从这些更大的社会和社区流程中确定途径 个人，自杀的青年韧性，以便与青年一起提供各种预防工作。 拟议的研究将使用协作混合方法方法：（a）确定可变的社区级别 似乎影响青年自杀的保护因素； （b）测试社区保护因素和 机制，在青年自杀弹性的多层次模型中； （c）发展和传播一个实用 评估和加强社区级保护并降低自杀风险并增加青年的工具 弹力。阿拉斯加本地弹性研究（ANRRS）具有以下特定目的：1）评估 一组可修改的文化，社区和机构因素（保护社区）的关联 自杀，自杀行为（构想，尝试）和相关的不良后果（偶然的因素） 死亡，需要医疗保健的饮酒）在64个农村和偏远的阿拉斯加本地村庄中识别 最可预测青年健康成果的社区级因素； 2）在分层的随机样本中 六个社区使用定量方法来测试个人级别青年保护性的多层次模型 由一组社区级别的因素主持的因素，作为个人水平青年韧性的预测因素 自杀风险结果； 3）开发和传播一种方法 - 阿拉斯加社区的弹性映射 （AK-CRM） - 为了社区衡量和战略性地加强这些社区级别的因素 增强其受保护的能力，以提高青年健康并降低自杀风险。进行 拟议的预防自杀研究我们的团队将与我们的长期社区研究伙伴合作 自杀率最高的三个阿拉斯加地区：西北北极，诺顿桑德和育空地区。 随着研究的进行，我们将与阿拉斯加本地协作中心分享初步结果 弹性研究（AnchRR）确保其在整个阿拉斯加的相关性，并将传播结果 全州的AK-CRM工具。部落知识和参与这项研究的融合将 满足当地需求，同时最大程度地提高研究的公共卫生影响。这项工作的目的是确定重要 社区级目标最有效地有助于减少青年自杀风险并促进 弹力。我们的方法将为社区成员提供一种文化响应的方法来记录和 以反映社区优先事项，认识论，本体论和实践的方式来增强自己的优势， 为预防自杀的可持续解决方案做出贡献