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

自杀是美国年轻人中一个主要的、日益严重的公共卫生问题。整合自杀 预防战略是提供保健服务的核心组成部分，并为以下方面提供保健服务 有自杀风险的个人是全国预防自杀行动联盟(NAASP)的主要目标。 缺乏普遍纳入常规保健的预防战略是实现 有意义地减少了青少年自杀。为了解决这一问题，我们建议发展该中心 在现实环境中加速自杀预防(ASPERS)，以加速实施有效的 和可扩展的循证干预措施，以减少青少年自杀。Apires将专注于集成 从初级保健和专科保健的早期识别到连续护理的研究方案 作为常规保健的一部分，从护理环境到急性和过渡性护理，再回到社区 练习一下。目标人群是自杀风险较高的青少年，其中大部分来自较低级别的人群 面临严重健康差距的社会经济家庭。ASIORS的具体目标包括： (1)建立基础设施，促进创新、跨学科的方法，以加快实施 和在现实世界环境中预防青少年自杀干预的效用；(2)开展综合方案 高影响力的研究，以改进风险检测并部署具有强大潜力的创新干预措施 在实际环境中实现可伸缩性和可持续性；(3)确定要生成的实现上下文的特征 针对不同的医疗保健环境提出对背景敏感的实施战略建议；(4) 培养来自不同背景的下一代新兴和先进学者来开展国家- 最先进的自杀预防研究；(5)协调一个试点研究计划，测试最有希望的 加快以实践为基础的青少年自杀预防创新的想法；和(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。中心的计划是 科学组合包括促进跨健康连续统一体的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-Level) 混合有效性--实施项目的重点是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)测试已建立的 在特殊护理环境中进行干预，以解决自杀行为的高家庭风险幼儿；2) 测试以家庭功能为目标的住院治疗的循证治疗替代品 减少青少年在急性护理环境中的自杀行为；以及3)开发以技术为基础的干预措施，以 在出院后的“高风险”过渡期内促进致命手段限制 精神病院。项目团队非常适合运营拟议中的中心，拥有来自多个国家的专业知识 学科和广泛的以社区为基础的利益攸关方和患者网络。

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.