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

自杀是美国青少年中一个主要且日益严重的公共卫生问题。整合自杀 预防战略作为卫生保健提供的核心组成部分，并为人们提供获得卫生服务的机会 有自杀风险的个人是国家自杀预防行动联盟 (NAASP) 的首要目标。 缺乏普遍融入日常卫生保健的预防策略是实现这一目标的障碍 显着减少青少年自杀率。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），以加快实施有效的自杀预防措施 以及可扩展的循证干预措施，以减少青少年自杀。 ASPIRE将专注于集成 研究计划涵盖从初级和专科健康早期识别开始的连续护理 护理环境，急性和过渡护理，并作为常规医疗保健的一部分返回社区 练习。目标人群是自杀风险较高的青少年，其中大多数来自较低阶层 社会经济家庭的健康状况存在显着差异。 ASPIRE 的具体目标包括： (1) 建立基础设施，促进创新、跨学科方法的实施，加速实施 青少年自杀预防干预措施在现实世界中的效用； （二）开展综合项目 高影响力的研究，以改善风险检测并部署具有强大潜力的创新干预措施 在现实环境中实现可扩展性和可持续性； (3) 表征生成的实现上下文 针对不同医疗保健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学者，进行国家研究 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 加速基于实践的青少年自杀预防创新的想法； (6) 沟通和 向主要利益相关者传播与中心相关的调查结果并促进数据共享。该中心规划 科学组合包括促进整个健康领域加速研究的综合努力 使用单独的项目机制无法完成的护理设置。签名（R01级） 混合有效性实施项目侧重于普遍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）测试已建立的 对特殊护理环境进行干预，以解决家庭自杀行为高风险的幼儿问题； 2） 测试以证据为基础的住院治疗替代方案，以家庭功能为目标 减少急症护理环境中的青少年自杀行为； 3) 制定基于技术的干预措施 提倡在出院后的“高风险”过渡护理期间限制致命手段 精神病医院。该项目团队非常适合运营拟议的中心，拥有来自多个领域的专业知识 学科以及广泛的基于社区的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.