A Prospective Study of Suicide Prevention in the USAF

描述（由申请人提供）：本提案的总体目标是使我能够发展成为一名独立调查员和一名主要学者所需的技能，以设计和评估基于社区的预防性心理健康干预研究的有效性。我的主要工作是预防自杀。我有一个独特的机会来评估，无论是回顾性的还是前瞻性的，美国空军开发的一个项目的效果，该项目可能已经实施了有效的战略来降低其成员的自杀率。美国空军的项目是社区层面预防的一个不寻常的例子，专门针对自杀预防，以及一般的心理健康疾病，整合了普遍和有针对性的预防方法。在美国，关于预防自杀和相关疾病的研究和项目已经萎缩，而其他公共卫生挑战却没有。部分原因是缺乏解决心理健康问题，特别是自杀问题的政治和社会意愿。最近，我们国家最高领导的公共卫生官员，美国卫生局局长认识到预防自杀和自杀行为是国家的优先事项。总之，我目前的能力，以访问一个“自然实验室”，在政治上的迫切性，以提高自杀预防领域的地位的气氛中，呈现出一个前景的巨大潜力，参与推进心理预防心理健康领域。随着心理健康预防性试验领域的发展，不仅能够进行项目评估，而且能够指导和开展现场试验以评估干预措施的有效性的研究人员的可用性将变得至关重要。我建议过渡到这一能力水平，通过与导师，专家顾问和合作者的跨学科团队进行严格的培训计划。这个职业发展奖将建立在我在流行病学和公共卫生，社会科学和基础科学研究已经很强的技能。它旨在提高我在预防性心理健康方面的知识和技能，重点是自杀，并发展适用于现场试验的调查方法的新技能。该提案的主要研究问题是调查美国空军自杀预防计划是否导致自杀事件减少，自杀未遂，以及相关的发病率，如家庭暴力，酗酒和抑郁症，并随着时间的推移保持减少。

DESCRIPTION (provided by applicant): The overall goal of this proposal is to allow me to develop the skills necessary to become an independent investigator and a leading scholar in the design and evaluation of the effectiveness of community-based preventive mental health intervention research. My primary focus will be on prevention of suicide. I have a unique opportunity to assess, both retrospectively and prospectively, the effects of a program developed in the United States Air Force that may have implemented effective strategies for reducing the suicide rate among its members. The program in the USAF is an unusual example of a community level prevention to address suicide prevention specifically, and mental health illness in general, integrating universal and targeted approaches to prevention. In the United States, research and programs on prevention of suicide and related morbidities has languished while other public health challenges have not. In part this has been due to the lack of political and social will to address mental health problems, especially suicide. Recently, our nation's top leading public health official, the U.S. Surgeon General recognized prevention of suicide and suicidal behaviors as a national priority. Taken together, my current capacity to access a "naturalistic laboratory", in a climate of political imperative to advance the status of the field of suicide prevention, renders a prospect of tremendous potential for participating in advancing the field of mental preventive mental health. As the field of preventive trials for mental health moves forward, the availability of investigators who are broadly trained not only to conduct program evaluations but also can direct and carry out field trials for the evaluation of the effectiveness of interventions will become vital. I propose to transition to this level of competency, through engaging in a rigorous training program with a interdisciplinary team of mentors, expert consultants and collaborators. This career development award will build upon my already strong skills in epidemiology and public health, social sciences, and basic science research. It is designed to enhance my knowledge and skills in preventive mental health, focusing on suicide, and to develop new skills in investigative methodologies applicable to field trials. The major research question of this proposal is to investigate whether the USAF Suicide Prevention Program results in a reduction in events of suicide, attempted suicide, and related morbidities, such as domestic violence, alcoholism and depression and maintains the reduction over time.