The BH-Works Suicide Prevention Program for Sexual and Gender Minority Youth

项目摘要 自杀是美国15至24岁人群的第二大死因。相比于其 异性恋和顺性别同龄人，性和性别少数（SGM）青少年报告显着高于 自杀意念和自杀企图的比率。不幸的是，许多障碍使 SGM社区的自杀预防。SGM青年经常报告说， 传统的行为健康服务机构。因此，治疗出勤率和保留率仍然 低相反，这一人群通常在社区组织中寻求女同性恋者的心理健康服务， gay，bisexual，transgender，and queer（LGBTQ）youth.同性恋、双性恋、变性者和酷儿青年。不幸的是，这些组织往往 对临床挑战毫无准备。行为健康工程（BH-Works）自杀风险管理 系统可以为这个问题提供潜在的解决方案。BH-Works是一个以证据为基础的综合性青年 自杀预防计划。它为政策制定、员工培训、自杀和行为提供支持。 健康检查、技术辅助安全规划、电子病人转诊系统、实时数据 项目监控分析，以及支持可持续发展的学习协作结构。所有功能 在一个便于实施、采用和扩展的基于网络的软件平台上得到支持。BH- Works已在临床和非临床环境中使用。在这个项目中，我们将调整这个程序， LGBTQ组织。该项目建立在与两个不同的LGBTQ组织建立强有力的伙伴关系的基础上 （Mazzoni中心，在费城和多样性营公司，在弗吉尼亚州西南部的农村）， 行为健康网站我们将使用一种灵活性-实现混合2型设计（Curran等人， 2013年）与历史比较组在两个LGBTQ组织内试点BH工程计划。 根据实施研究综合框架，我们将对一个有序的 实施战略这一战略的重点是促进参与，建立伙伴关系， 可持续性在第一年，我们将收集治疗数据，与我们的合作伙伴一起调整BH-Works 内容、实践和工作流程。我们还将培训工作人员/提供者在自杀风险管理，家庭 参与和扶持性护理。在第二年，我们将开始试点测试SGM BH-Works筛选， 转介系统。我们将评估主要项目成果（增加自杀识别和成功 转介），次要结果（计划可接受性），并探索计划机制（培训影响， 伙伴关系发展、软件可用性和护理人员参与）。拟议的研究回应了 国家越来越需要识别和转介有自杀风险的弱势青年。未来的R 01将测试 更大样本和不同实施策略的计划有效性。

PROJECT ABSTRACT Suicide is the second leading cause of death for 15-to-24-year-olds in the United States. Compared to their heterosexual and cisgender peers, sexual and gender minority (SGM) adolescents report significantly higher rates of suicidal ideation and suicide attempts. Unfortunately, many barriers complicate the implementation of suicide prevention in SGM communities. SGM youth often report feeling unwelcome and misunderstood in traditional behavioral health service organizations. Consequently, treatment attendance and retention remain low. Instead, this population generally seeks mental health services in community organizations for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. Unfortunately, these organizations are often unprepared for this clinical challenge. The Behavioral Health-Works (BH-Works) suicide risk management system may offer a potential solution to this problem. BH-Works is an evidence-based, comprehensive youth suicide prevention program. It offers support for policy development, staff training, suicide and behavioral health screening, technology-assisted safety planning, an electronic patient referral system, real-time data analytics for program monitoring, and a learning collaborative structure to support sustainability. All functions are supported on a web-based software platform that facilitates implementation, adoption and expansion. BH- Works has been used in both clinical and non-clinical settings. In this project, we will adapt this program for LGBTQ organizations. This project builds upon robust partnerships with two diverse LGBTQ organizations (Mazzoni Center, in Philadelphia and Diversity Camp Inc., in rural Southwest, Virginia) and partnering behavioral health sites. We will use an Effectiveness-Implementation Hybrid Type 2 design (Curran et al., 2013) with a historical comparison group to pilot the BH-Works program within the two LGBTQ organizations. Informed by the Consolidated Framework for Implementation Research, we will pilot test a sequenced implementation strategy. This strategy focuses on promoting engagement, building partnership, , and creating sustainability In Year 1, we will collect treatment as usual data, work with our partners to adapt BH-Works content, practices, and workflow. We will also train staff/providers in suicide risk management, family engagement and affirmative care. In Year 2, we will begin pilot testing the SGM BH-Works screening and referral systems. We will evaluate primary program outcomes (increased suicide identification and successful referrals), secondary outcomes (program acceptability), and explore program mechanisms (training impact, partnership development, software usability and caregiver involvement). The proposed research responds to the growing national need to identify and refer vulnerable youth at risk for suicide. A future R01 will test program effectiveness with a larger sample and different implementation strategies.