Adaptation and Pilot Test of a Universal School-Based Suicide Prevention Program

普遍的基于学校的自杀预防计划的适应和试点测试

• 批准号: 10338185
• 负责人: Holly C Wilcox
• 金额: $ 24.57万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10338185
• 关键词: 13 year old; 16 year old; Accident and Emergency department; Acute; Address; Adolescent; Adolescent Risk Behavior; African American; African American population; African American student; Age; Awareness; Baltimore; Cause of Death; Centers for Disease Control and Prevention (U.S.); Child; Cities; Clinical Trials; Communities; Coping Skills; Country; Data; Depressed mood; Depression and Suicide; Development; Educational Curriculum; Epidemiological trend; Europe; European; European Union; Evidence based intervention; Evidence based program; Eye; Feeling suicidal; Female; Future; Grant; Health; Health education; Heterogeneity; High School Student; Incidence; Inpatients; International; Intervention; Knowledge; Leadership; Maryland; Mental Health; Mental health promotion; Methods; Middle School Student; Mind; National Institute of Mental Health; Outcome; Participant; Persons; Pilot Projects; Population; Prevention; Prevention program; Problem Solving; Public Health; Randomized; Registries; Reporting; Research Design; Risk Factors; Safety; School-Age Population; Schools; Services; Strategic Planning; Students; Suicide; Suicide attempt; Suicide prevention; Surveys; System; Testing; Time; Training Programs; United States; Urban Population; Visit; Waiting Lists; Youth; acceptability and feasibility; age group; aged; base; boys; coping; critical period; design; disability; early adolescence; effectiveness evaluation; effectiveness trial; eighth grade; evidence base; flexibility; girls; health disparity; health literacy; health training; high risk; high school; instructor; intervention effect; junior high school; modifiable risk; mood symptom; personalized intervention; pilot test; pilot trial; prevent; primary outcome; programs; racial disparity; racial diversity; randomized trial; recruit; response; screening; seventh grade; skills; stressor; suicidal behavior; suicidal morbidity; suicidal risk; suicide rate; teacher; uptake

The Centers for Disease Control and Prevention reported that the suicide rate for females aged 10 –14 has had the largest percent increase (200%) of any other demographic group between 1999 and 2014, tripling from 0.5 per 100,000 in 1999 to 1.5 in 2014. Although the rates of suicide are relatively rare in these ages, as compared to older ages, the sharp increase in suicide among young people is alarming. Data from the 2016 Youth Risk Behavior Surveillance System showed that 27% of Baltimore City middle school students (ages 11- 14) reported having ever thought about killing themselves and 14% had ever attempted suicide. With suicide being the second leading cause of death for persons ages 10-14, it is important to target prevention efforts early. Almost all of the existing suicide prevention programs target suicide risk in high school, which is too late to meet the needs of middle school students. The primary aim of this R34 pilot effectiveness trial is to establish the feasibility, acceptability, preliminary impact, and potential for future uptake of the Youth Aware of Mental Health (YAM) program. YAM is an evidence-based mental health promotion program administered in schools that has been shown to be effective among primarily white European high school students ages 14 to 16 years old. In a large randomized trial involving 11,110 students from 168 schools in ten European Union countries, students randomized to YAM reported 55% lower incidence of suicide attempts and 50% lower incidence of severe suicidal ideation over one year. YAM was chosen for the proposed study not just because of these outcome data, but because it aligns with U.S. National Health Education Standards, and because it was created with the heterogeneity of youth in mind. Our adaptation and implementation of YAM will include five sessions delivered in middle school health education class by trained health education teachers. Given its flexibility, YAM was designed with an eye toward community implementation, sustainment and scalability. YAM’s proposed target mechanisms of action involve enhancing problem-solving and coping skills to manage acute stressors. This pilot study will examine feasibility and acceptability of the proposed recruitment methods, research design, intervention, assessment methods and training program in a school system with a majority African American population by matching 7th and 8th grade classrooms by school and randomizing classrooms to YAM or to the wait-list control condition. The primary outcomes will be suicidal ideation and mood symptoms in the 3 months after YAM implementation. This proposed pilot effectiveness trial will lay the groundwork for a larger clinical trial (R01) to evaluate the effectiveness of YAM on suicidal behaviors in urban middle school students.

疾病控制和预防中心报告说，10 - 14岁女性的自杀率 在1999年至2014年期间，任何其他人口群体的增长率最高（200%），从1999年到2014年， 0.5从1999年的每100 000人中有1.5人降至2014年的1.5人。虽然自杀率在这些年龄段相对罕见， 与年长者相比，年轻人自杀率的急剧上升令人震惊。2016年数据 青少年危险行为监测系统显示，27%的巴尔的摩市中学生（11- 14)报告说，他们曾经想过自杀，14%的人曾经试图自杀。与自杀 作为10-14岁人群死亡的第二大原因，必须有针对性地开展预防工作 早了几乎所有现有的自杀预防计划都针对高中的自杀风险，这已经太晚了 以满足中学生的需求。这项R34试点有效性试验的主要目的是建立 可行性，可接受性，初步影响，以及未来吸收的潜力， 健康（YAM）计划。YAM是一个在学校管理的以证据为基础的心理健康促进计划 这在年龄在14到16岁的欧洲白色高中生中是有效的 老了在一项涉及来自十个欧盟国家168所学校的11，110名学生的大型随机试验中， 被随机分配到YAM的学生报告说，自杀企图的发生率降低了55%， 一年内有严重自杀意念。选择YAM进行拟议的研究不仅仅是因为这些 结果数据，但因为它符合美国国家健康教育标准，因为它是 在创作时考虑到了青年的异质性。我们对YAM的调整和实施将包括五个方面 由受过培训的健康教育教师在中学健康教育课上授课。鉴于其 灵活性，YAM的设计着眼于社区实施，可持续性和可扩展性。 YAM提出的目标行动机制包括提高解决问题和应对技能， 急性应激源这项试验性研究将审查拟议征聘方法的可行性和可接受性， 研究设计，干预，评估方法和培训计划，在学校系统中，大多数 非裔美国人人口，按学校和随机教室匹配7年级和8年级教室 到YAM或到等待列表控制条件。主要结果将是自杀意念和情绪症状 在YAM实施后的3个月内。这项拟议的试点成效试验将为 评价YAM对城市中学自杀行为有效性的大型临床试验（R 01） 学生

项目成果

Risk and Protective Factors Associated with Suicidal Thoughts and Behaviors Among Maryland Middle School Students.

• DOI: 10.1007/s12310-022-09521-6
• 发表时间: 2022
• 期刊: SCHOOL MENTAL HEALTH
• 影响因子: 2.6
• 作者: Flores, Jean P.;Stuart, Elizabeth A.;Swartz, Karen L.;Jallah, Nikardi A.;Wilcox, Holly C.
• 通讯作者: Wilcox, Holly C.