Cultural Consensus Modeling to Identify Culturally Relevant Risk Factors for Suicide among Black Youth

文化共识模型识别黑人青年自杀的文化相关风险因素

• 批准号: 10528029
• 负责人: Jennifer L Brown
• 金额: $ 26.53万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10528029
• 关键词: Adult; Age; Belief; Black race; Client; Consensus; Death Rate; Dropout; Empirical Research; Ethnography; Feeling suicidal; Female; Future; Gender; Heterogeneity; Individual; Individual Differences; Intervention; Interview; Knowledge; Maps; Measures; Mental Depression; Mental Health; Mental Health Services; Methodology; Methods; Modeling; Motivation; Nature; Participant; Phase; Population; Prevention program; Process; Property; Psychiatry; Psychological Theory; Psychometrics; Public Health; Questionnaires; Research; Research Personnel; Risk; Risk Factors; Sampling; Severities; Structural Racism; Subgroup; Suicide; Suicide attempt; Suicide prevention; Testing; Theoretical model; Time; Voice; Work; Youth; base; career; evidence base; expectation; experience; informant; intersectionality; intervention program; lens; peer; predictive modeling; public health relevance; racial discrimination; recruit; research and development; response; social; suicidal behavior; suicidal morbidity; suicidal risk; theories; therapy development

ABSTRACT Between 1991 and 2017 there was a 73% increase in suicide attempts among Black youth. Black youth <13 are twice as likely to die by suicide compared to White peers. Theoretical models (e.g. Interpersonal-Psychological Theory of Suicide; IPTS) and the interventions they inform have largely utilized non-Black, non-youth, samples, limiting their relevance for Black youth. Our team, which include two Black early career researchers will be the first to make use of a rigorous, multi-method, ethnographic approach, namely Cultural Consensus Modeling (CCM), to give direct voice to the reasons for suicidal thoughts and behaviors in Black youth, ages 11-17, in the form of cultural models generated by Black youth themselves. We will then evaluate cultural models for their association with more traditional suicide predictors derived from IPTS (perceived burdensomeness, thwarted belongingness, acquired capability), in addition to variables related to social injustice, in particular racial discrimination. Guided by a conceptual framework that integrates IPTS and Intersectionality, our central hypothesis is that derived cultural models will point to the importance of redefining IPTS variables through the lens of racial discrimination. The CCM methodology is iterative in nature with initial study phases informing subsequent phases, verifying and further testing derived cultural models. Aim 1 will recruit 50 at-risk Black youth (50% female), as determined by past suicidal ideation or behaviors and moderate-severe depression scores. Making use of “free listing” CCM methodology, youth will be asked to identify risk factors (common reasons) for suicidal thoughts and behaviors among peer Black youth. We hypothesize that Black youth will generate IPTS-related motivations for suicide as well as motivations related to racial discrimination. Aim 2 will recruit a new sample of 100 at-risk Black youth (50% female) who will rate the culture-relevance of factors generated in Aim 1 on a 5-point likert scale. We hypothesize that more than one cultural consensus model (clusters) will emerge given expected heterogeneity (sub-cultures) in the population. Aim 3 will utilize a subset of participants (N=25; 50% female) who completed Aim 2 to represent each identified cultural model from Aim 1. Qualitative interviews will be conducted to gather in-depth information on each cultural model. Informed by the results of Aims 1-3, Aim 4 will recruit a new sample of 200 at-risk Black youth (50% female), alongside measures of IPTS and racial discrimination to test the hypotheses that (1) cultural models will map well onto own reasons for suicidal thoughts and behaviors; (2) cultural models will align with individual differences in IPTS and racial discrimination, and that (3) models that align with racial discrimination will most strongly predict suicide severity, pointing to the importance of redefining IPTS variables through the lens of racial discrimination. The proposed work responds to urgent calls for research on the risk factors for suicidal behaviors in Black youth and will, for the first time, provide empirically derived treatment targets for culturally relevant treatment adaptation of IPTS and other suicide prevention programs.

抽象的 在1991年至2017年之间，黑人青年的自杀企图增加了73％。黑人青年<13是 与白人同龄人相比，自杀死亡的可能性是两倍。理论模型（例如人际心理学 自杀理论； IPTS）以及他们所告知的干预措施在很大程度上使用了非黑色，非年轻，样本， 限制他们对黑人青年的相关性。我们的团队，包括两个黑人早期职业研究人员将是 首先利用严格的多方法，人种学方法，即文化共识建模 （CCM），直接表达了11-17岁的黑人青年自杀思想和行为的原因 黑人青年本身产生的文化模型的形式。然后，我们将评估文化模型 他们与来自IPT的更传统的自杀预测因素（可感知的耐磨，， 除了与社会伤害有关的变量外，挫败归属感，获得的能力），特别是 种族歧视。以整合IPT和交叉性的概念框架为指导，我们的中心 假设是，衍生的文化模型将指出重新定义IPT变量的重要性 种族歧视的镜头。 CCM方法本质上是迭代性的，初步研究阶段告知 随后的阶段，验证和进一步测试得出的文化模型。 AIM 1将招募50个处于危险的黑色 青年（50％女性），由过去的自杀思想或行为和中等重度抑郁症确定 分数。利用“免费上市” CCM方法论，将要求青年确定风险因素（常见 原因）在同伴黑人青年中自杀思想和行为。我们假设黑人青年会 产生与IPTS相关的自杀动机以及与种族歧视有关的动机。 AIM 2意志 招募100个处于危险的黑人青年（50％女性）的新样本，这些样本将评估因素的文化权威 在AIM 1中以5分李克特量表生成。我们假设多个文化共识模型 （集群）将出现在人群中的预期异质性（亚文化）。 AIM 3将使用子集 完成AIM 2的参与者（n = 25; 50％女性）代表AIM的每个已确定的文化模型 1。将进行定性访谈，以收集每个文化模型的深入信息。告知 AIMS 1-3的结果，AIM 4将招募一个新的样本 200 处于危险的黑人青年（50％女性） IPT和种族歧视的措施，以测试（1）文化模型将很好地映射到 自杀思想和行为的理由； （2）文化模型将与个人差异保持一致 IPT和种族歧视，（3）与种族歧视保持一致的模型将最强烈预测 自杀严重程度，指出通过种族镜头重新定义IPT变量的重要性 歧视。拟议的工作回应紧急呼吁对自杀的风险因素进行研究 黑人青年的行为，并将首次为文化提供经验得出的治疗目标 IPT和其他预防自杀计划的相关治疗适应。