Youth Suicide Prevention: Maintaining Long Term Change

自杀仍然是年轻人死亡的主要原因-每年有五分之一的青少年考虑自杀，大约有一百万人试图自杀。这些比率继续上升到年轻的成年。青少年自杀风险行为是一个重大的公共卫生问题，值得立即关注的关键干预因素，促进短期和维持长期的行为改变。本提案检查了参与指定自杀预防计划后与长期行为变化相关的心理社会过程，并专门响应RFA OB-03-003。该提案利用了一项即将完成的预防试验，由国家护理研究所资助的促进护理。该计划已经证明了对易自杀的高中青年的短期效果。促进关怀研究将提供大约550名弱势青年的样本，随机分配到3个实验条件中的1个，并与“照常”干预进行比较。“这项研究得到了严格的实施，在基线、干预后、基线后9个月和15个月以及30个月时收集了大量的测量数据。 通过延长至48个月的随访，我们将1）测试长期干预效果; 2）测试理论模型，检查短期和长期行为结果的中介干预效果; 3）确定随时间变化的轨迹。先进的统计程序（潜在增长模型，SEM）将用于检查行为变化和测试假设的中介干预效果。将使用多方法方法和探索性分析策略来检查干预过程和生命历程因素对变化模式的影响。该研究具有创新性和重要意义，对理论检验和预防科学具有重要意义。这项研究应该显着增加我们对青年和家庭为重点的预防性干预措施的方式的理解自杀脆弱的青年工作，以遏制抑郁，愤怒和自杀风险行为。

DESCRIPTION (provided by applicant): Suicide remains a leading cause of death among young people--each year 1 in 5 teenagers considers suicide and approximately one million attempt suicide. These rates continue to escalate into young adulthood. Youth suicide-risk behavior is a major public health problem deserving immediate attention to critical intervention factors that promote short-term and maintain long-term behavioral change. This proposal examines psychosocial processes associated long-term behavioral change following participation in an indicated suicide prevention program, and responds specifically to RFA OB-03-003. The proposal takes advantage of a nearly completed prevention trial, Promoting CARE funded by the National Institute for Nursing Research. The program has demonstrated short-term outcome effects for suicide-vulnerable high school youth. The Promoting CARE study will provide a sample of approximately 550 vulnerable youth, randomly assigned to 1 of 3 experimental conditions, and compared to intervention "as usual." The study has been rigorously implemented, with extensive measures collected at baseline, post-intervention, 9 and 15 months post-baseline, and, for half the sample, at 30 months. With an extended follow-up to 48 months, we will 1) test for long-term intervention effects; 2) test the theoretic model, examining for mediational intervention effects on both short- and long-term behavioral outcomes; and 3) identify trajectories of change across time. Advanced statistical procedures (latent growth models, SEM) will be used to examine behavioral change and to test hypothesized mediating intervention effects. The influence of intervention processes and life course factors on patterns of change will be examined using multi-method approaches and exploratory analytic strategies. The proposed study is innovative and significant; it has implications for theory testing and prevention science. This research should markedly increase our understanding of ways in which youth and family-focused preventive interventions for suicide-vulnerable youth work to curb depression, anger and suicide-risk behaviors.