Cultural-Social Engagement and Suicideamong Hispanics

西班牙裔人的文化社会参与和自杀

• 批准号: 10301466
• 负责人: Caroline Silva
• 金额: $ 18.17万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10301466
• 关键词: Adolescent; Adult; Aftercare; Behavior Therapy; Behavioral; Cellular Phone; Cessation of life; Clinical; Clinical Trials; Cognitive; Communities; Coupled; Data; Development; Ecological momentary assessment; Elements; Ethics; Event; Evidence based intervention; Expectancy; Family; Feedback; Feeling; Feeling suicidal; Foundations; Friends; Funding; Geography; Goals; Health; Hispanics; Home; Human; Individual; Intervention; Interview; Investigational Therapies; Language; Linguistics; Link; Location; Measures; Mental Depression; Mental Health; Mentors; Methodology; Minority Groups; Monitor; National Institute of Mental Health; Nature; Outcome; Outpatients; Participant; Patient Self-Report; Perception; Population; Prevention Research; Prevention program; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Research; Research Project Grants; Risk; Role; Sampling; Severities; Social Behavior; Social Interaction; Structure; Suicide; Suicide prevention; Techniques; Technology; Testing; Therapeutic; Time; Training; Treatment Protocols; Underserved Population; United States; Visit; Well in self; Work; attenuation; base; career development; cultural values; design; follow-up; ideation; improved; in vivo; innovation; interest; novel; post intervention; preventive intervention; programs; protective factors; psychologic; racial and ethnic; rapid growth; reducing suicide; research study; skills; social; social engagement; social factors; social interventions; suicidal risk; suicide rate; theories

ABSTRACT Suicide rates among Hispanics in the United States have increased in the last two decades; coupled with rapid growth of the Hispanic population, suicide among Hispanics is a pressing public health issue. Considering the role of culture in suicide can elucidate unique and modifiable mechanisms for suicide. The Candidate’s long- term research goal is to optimize suicide prevention interventions for Hispanics by targeting cultural determinants of health. Reaching that goal requires mentored training in three domains of suicide prevention research and completion of a research project to produce substantive, foundational results (described below). First, the candidate needs to gain expertise in randomized clinical trials methodology for suicide interventions (Objective 1) to conduct a trial with at risk Spanish-speaking adults in a reliable, valid, and ethical manner, and test target engagement with an experimental therapeutics approach. Second, the candidate needs to gain expertise in optimizing behavioral interventions to impact cultural determinants of health via human-centered design (Objective 2) to deliver a treatment protocol that is culturally-usable and optimized to increase cultural- social engagement. Third, as smartphone technology increases precision to measure mechanisms, the candidate needs to gain expertise in the use of novel smartphone technology for precise assessment of target engagement in clinical trials (Objective 3) to optimally/ethically use this technology in clinical trials research. The principal objective of the proposed research study is to use an experimental therapeutics approach to examine whether a behavioral intervention (SOCIAL ENGAGE; S-ENGAGE) can increase cultural-social engagement (intervention target) and decrease suicide risk (clinical outcome) among Hispanic adults. First, human-centered design approaches will be used to iteratively refine and optimize S-ENGAGE to alter cultural-social engagement via iterative feedback from 5 Spanish-speaking adults with low cultural-social engagement and recent ideation. Second, 60 Spanish-speaking adults who report low cultural-social engagement and recent ideation will be randomized into 10-weeks of S-ENGAGE or an expectancy-matched control. Participants will provide 2-weeks of real-time data via smartphone at baseline, post-treatment, and 3- month follow-up and complete semi-structured interviews. Research Aims are to: (1) Optimize S-ENGAGE for target engagement. (2) Test target engagement: Does S-ENGAGE increase cultural-social engagement among Spanish-speaking adults?; (3) Test clinical impact: Does S-ENGAGE decrease suicide risk among Spanish-speaking adults?; (4) To contextualize findings: What components of S-ENGAGE were most helpful? The resulting findings of this K23 project will function as the basis for a larger R01-funded study powered to examine whether the proposed target (cultural-social engagement) leads to changes in the clinical outcome (suicide ideation). The candidate will build on the skills acquired in this period of mentored career development to contribute to the development and refinement of approaches to suicide prevention for Hispanics.

摘要 在过去的二十年里，美国西班牙裔美国人的自杀率有所上升;再加上快速增长， 随着西班牙裔人口的增长，西班牙裔人的自杀是一个紧迫的公共卫生问题。考虑 文化在自杀中的作用可以阐明自杀的独特和可改变的机制。候选人的长期- 长期的研究目标是通过针对西班牙裔的文化， 健康的决定因素。要实现这一目标，需要在预防自杀的三个领域进行指导性培训 研究和完成一个研究项目，以产生实质性的基础成果（见下文）。 首先，候选人需要获得自杀干预随机临床试验方法的专业知识 （目标1）以可靠、有效和符合伦理的方式，在有风险的讲西班牙语的成年人中进行试验， 用实验性治疗方法测试目标接合。其次，候选人需要获得 在优化行为干预方面的专业知识，通过以人为本的方式影响健康的文化决定因素 设计（目标2）提供一个文化上可用的和优化的治疗方案，以增加文化- 社会参与第三，随着智能手机技术提高了测量机制的精度， 候选人需要获得使用新型智能手机技术的专业知识，以精确评估目标 参与临床试验（目标3），以最佳/道德地在临床试验研究中使用该技术。 拟议研究的主要目的是使用实验治疗方法， 检查行为干预（社会参与; S-ENGAGE）是否可以增加文化社会 参与（干预目标）并降低西班牙裔成年人的自杀风险（临床结果）。 首先，以人为本的设计方法将用于迭代地改进和优化S-ENGAGE，以改变 通过5名文化社会参与度低的西班牙语成年人的迭代反馈， 参与度和最近的想法。第二，60名说西班牙语的成年人，他们报告说， 参与和最近的想法将被随机分为10周的S-ENGAGE或预期匹配的 控制受试者将通过智能手机提供基线、治疗后和治疗后3周的实时数据。 一个月的随访和完整的半结构化访谈。研究目的是：（1）优化S-ENGAGE， 瞄准目标(2)测试目标参与度：S-ENGAGE是否增加了文化社会参与度 在讲西班牙语的成年人中？(3)测试临床影响：S-ENGAGE是否降低了 讲西班牙语的成年人？(4)将研究结果置于情境中：S-ENGAGE的哪些组成部分最有帮助？ 该K23项目的结果将作为R 01资助的更大研究的基础， 检查拟议目标（文化-社会参与）是否会导致临床结局的变化 （自杀意念）。候选人将在这一指导职业发展期间获得的技能基础上发展 为西班牙裔自杀预防方法的发展和完善做出贡献。