The Center for Accelerating Suicide Prevention in Real-world Settings (ASPIRES)

自杀是美国青年中一个主要的和日益严重的公共卫生问题。整合自杀 预防战略作为提供保健服务的核心组成部分， 预防自杀是国家预防自杀行动联盟（NAASP）的主要目标。 缺乏普遍纳入日常保健的预防战略是实现千年发展目标的障碍， 减少青少年自杀。为了解决这个问题，我们建议建立一个中心， 加速现实世界中的自杀预防（ASPIRES），以加快实施有效的 和可扩展的循证干预措施，以减少青年自杀。ASPIRES将专注于集成 研究计划，从初级和专业健康的早期识别跨越护理的连续性 护理环境，急性和过渡性护理，并返回社区作为常规卫生保健的一部分 实践目标人群是自杀风险较高的青少年，其中大多数来自较低的 社会经济家庭的健康状况存在显著差异。ASPIRES的具体目标包括： (1)建立基础设施，促进创新的跨学科方法，以加速执行 和实用的青年自杀预防干预措施在现实世界的设置;（2）进行综合方案， 高影响力的研究，以改善风险检测和部署具有强大潜力的创新干预措施 在现实世界中的可扩展性和可持续性;（3）描述实现环境，以生成 针对不同医疗环境的情境敏感实施策略的建议;（4） 培养来自不同背景的下一代新兴和先进的学者进行国家- 最先进的自杀预防研究;（5）协调试点研究计划，测试最有希望的 （六）加强青少年自杀预防工作的沟通， 向主要利益攸关方传播与中心有关的调查结果，并促进数据共享。中心计划 科学组合包括促进整个健康连续体加速研究的综合努力 利用个别项目机制无法完成的护理环境。签名（R 01级） 混合有效性-实施项目侧重于普遍的自杀风险筛查和提高质量 改善儿科初级保健环境。三个探索性项目包括：1）测试一个已建立的 在专业护理环境中进行干预，以解决家庭自杀行为高风险的幼儿; 2） 测试以证据为基础的治疗替代住院治疗，目标是家庭功能， 减少急性护理环境中的青少年自杀行为; 3）开发基于技术的干预措施， 促进在从一个医院出院后的“高风险”过渡性护理期间限制使用致命手段; 精神病院项目团队非常适合运行拟议的中心，拥有多个 学科和广泛的社区利益相关者和患者网络。

Suicide is a major and growing public health problem among youth in the United States. Integrating suicide prevention strategies as a core component of health care delivery and providing access to health services for individuals at risk for suicide is a primary goal of the National Action Alliance for Suicide Prevention (NAASP). Lack of prevention strategies universally assimilated into routine health care is an obstacle to achieving meaningful reductions in youth suicide. To address this problem, we propose to develop the Center for Accelerating Suicide Prevention in Real-world Settings (ASPIRES) to hasten the implementation of effective and scalable evidence-based interventions to reduce youth suicide. ASPIRES will focus on integrated programs of research that span the continuum of care from early identification in primary and specialty health care settings, to acute and transitional care, and back into the community as part of routine health care practice. The target population is youth at elevated risk for suicide, the majority of which are from lower socioeconomic households experiencing significant health disparities. The specific aims of ASPIRES include: (1) Create an infrastructure to foster innovative, transdisciplinary approaches to accelerate the implementation and utility of youth suicide prevention interventions in real-world settings; (2) Conduct integrated programs of high-impact research to improve risk detection and deploy innovative interventions that have strong potential for scalability and sustainability in real-world settings; (3) Characterize the implementation context to generate recommendations for contextually sensitive implementation strategies for varied healthcare settings; (4) Cultivate the next generation of emerging and advanced scholars from diverse backgrounds to conduct state- of-the-art suicide prevention research; (5) Coordinate a program of pilot studies that test the most promising ideas to accelerate innovations in practice-based youth suicide prevention; and (6) Communicate and disseminate center-related findings to key stakeholders and promote data sharing. The center’s planned portfolio of science includes integrated efforts promoting accelerated research across a continuum of health care settings that could not be accomplished using individual project mechanisms. The signature (R01-level) hybrid effectiveness-implementation project focuses on universal suicide risk screening and enhancing quality improvement in pediatric primary care settings. Three exploratory projects include: 1) testing an established intervention in a specialty care setting to address young children at high familial risk for suicidal behavior; 2) testing an evidence-based treatment alternative to inpatient hospitalization that targets family functioning to reduce youth suicidal behavior in an acute care setting; and 3) developing a technology-based intervention to promote lethal means restriction during the “high-risk” transitional care period following discharge from a psychiatric hospital. The project team is well-suited to run the proposed center with expertise from multiple disciplines and an extensive community-based stakeholder and patient network.