The Elders' Resilience Curriculum: Toward Building Empirical Evidence for a Culturally Grounded American Indian Youth Suicide Prevention Intervention

项目总结 自杀对美国印第安人/阿拉斯加原住民(AI/AN)社区的影响不成比例，其中 人工智能/人工智能儿童和青少年所经历的负担。A人工智能/人工智能中的精神卫生保健资源匮乏 环境表明，迫切需要在传统精神健康之外提供自杀预防干预措施 临床环境。过去的研究表明，文化保护因素方法将比风险更有效- 有针对性的干预措施，以减少AI/AN青少年自杀。有文化根基(或“根深蒂固”)的预防 干预措施-将当地文化和价值观置于干预措施设计、实施和 评估-坚定承诺防止AI/AN青少年自杀。然而，我们对CORE知之甚少 以文化为基础的干预可以防止自杀的组件、机制和结构。 老年人复原力课程(ERC)是一项以学校为基础、以文化为基础的自杀预防课程 目前由白山阿帕奇部落(WMAT)长老通过每月课程提供的干预 向9-14岁的青少年介绍部落文化价值观、信仰、生活方式和阿帕奇语言，这是一个新阶段 在本社区自杀高危时期(15-24岁)之前。拟议的研究建立了 约翰霍普金斯美国印第安人健康中心和WMAT的35年以上的研究和公共卫生 通过以社区为基础继续创新和扩大预防干预措施的伙伴关系 参与式研究。候选人将与部落大学合作伙伴进行一次探索性的 确定关键自杀保护因素和ERC核心成分的序贯混合方法研究 针对这些因素，改进指定因果机制和结果的理论模型，制定 适应文化的评估单元，并试行严格的评估以测试理论模型和 文化适应措施，为更大规模的R01有效性研究做准备。如果成功，就会有新的理解 ERC通过哪些机制和结构来预防AI/AN青少年自杀将支持 将这一干预措施复制和推广到其他遭受青年自杀差距的人工智能/人工智能社区。这个 拟议的K01将为来自切诺基/塞米诺尔民族的候选人提供关键的培训 定性和混合方法研究，基于文化的干预设计和评估，以及 儿童/青少年发展，因为它与复原力、文化认同和自杀预防有关。候选人 将接受由国家专家组成的指导团队的指导和有针对性的培训 土著心理健康预防科学。这一K01奖项将支持她成为一名土著NIMH 独立调查者专注于了解文化知识、基于优势的心理健康促进研究。 建议的研究和候选人的职业目标与NIMH战略目标4保持一致，以“加强 NIMH支持的研究的公共卫生影响“和”确定、验证和扩大创新计划 目前正在使用，以改善服务不足人群的精神卫生服务“(4.1)。

PROJECT SUMMARY Suicide disproportionately affects American Indian/Alaska Native (AI/AN) communities, with the greatest burden experienced by AI/AN children and adolescents. A paucity of mental health care resources in AI/AN settings points to a critical need to deliver suicide prevention interventions outside conventional mental health clinical settings. Past research has shown cultural protective factor approaches will be more effective than risk- focused interventions to reduce AI/AN youth suicide. Culturally grounded (or “ground up”) prevention interventions—which place local culture and values at the forefront of intervention design, implementation, and evaluation—hold strong promise to prevent AI/AN youth suicide. However, we know little about core components, mechanisms, and constructs through which culturally grounded interventions can prevent suicide. The Elders’ Resilience Curriculum (ERC) is a school-based, culturally grounded, suicide prevention intervention currently delivered by White Mountain Apache Tribe (WMAT) Elders through monthly lessons about tribal cultural values, beliefs, ways of life, and Apache language to youth ages 9-14, a nascent stage prior to the highest risk period for suicide (15-24 years old) in this community. The proposed research builds upon the Johns Hopkins Center for American Indian Health and WMAT’s 35+ year research and public health partnership that continues to innovate and scale prevention interventions through community-based participatory research. The candidate will engage with the tribal-university partners to conduct an Exploratory Sequential Mixed Methods study to identify key suicide protective factors and ERC core components that target these factors, refine a theoretical model specifying causal mechanisms and outcomes, develop a culturally adapted assessment battery, and pilot a rigorous evaluation to test the theoretical model and culturally adapted measures to prepare for a larger R01 effectiveness study. If successful, new understanding of the mechanisms and constructs through which ERC operates to prevent AI/AN youth suicide will support replication and scaling of this intervention to other AI/AN communities suffering youth suicide disparities. The proposed K01 will provide the candidate, who is from the Cherokee/Seminole Nations, with critical training in qualitative and mixed methods research, culturally grounded intervention design and evaluation, and child/adolescent development as it relates to resiliency, cultural identity, and suicide prevention. The candidate will receive guidance and targeted training from a mentorship team of national experts at the forefront of Indigenous mental health prevention science. This K01 award will support her to become an Indigenous NIMH independent investigator focused on culturally-informed, strengths-based mental health promotion research. The proposed research and candidate’s career goals align with NIMH Strategic Objective 4 to “strengthen the public health impact of NIMH-supported research” and “identify, validate, and scale-up innovative programs currently in use that improve mental health services for underserved populations” (4.1).