Individual and Community and Organizational Factors for Suicide Risk in the USAF

美国空军自杀风险的个人、社区和组织因素

• 批准号: 9085363
• 负责人: Kerry L Knox
• 金额: $ 50.73万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-24 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9085363
• 关键词: Age; Air; Air Force Personnel; American; Beryllium; Communities; Complex; Data; Data Sources; Databases; Department of Defense; Development; Early identification; Effectiveness; Effectiveness of Interventions; Evaluation; Event; Funding; Future; General Population; Goals; Health; Health Policy; Human Resources; Individual; Interpersonal Violence; Intervention; Journals; Leadership; Legal; Life; Link; Location; Marital Status; Measures; Mediating; Mediator of activation protein; Modeling; Modification; Morbidity - disease rate; National Institute of Mental Health; Occupations; Outcome; Pathway interactions; Personal Satisfaction; Phase; Play; Population; Prevention; Prevention program; Preventive; Printing; Privacy; Process; Psychiatric Diagnosis; Public Health; Recovery; Refractory; Research; Research Methodology; Resources; Risk; Risk Factors; Role; Schools; Secure; Services; Social support; Source; Specificity; Stress; Subgroup; Suicide; Suicide attempt; Suicide prevention; Testing; Thinking; Time; United States; Update; Violence; Work; base; cohort; contextual factors; effective intervention; experience; high risk; innovation; interest; intervention program; member; mortality; novel; population based; predictive modeling; programs; reducing suicide; resilience; stressor; suicidal behavior; suicidal morbidity; suicidal risk; suicide rate

DESCRIPTION (provided by applicant): In 2006 we were funded through 1 R01 MH075017 to study the relationship between implementation and reductions in events of suicide in the United States Air Force (AF). In order to do that, we proposed to link individual level data from the AF personnel files for each of the covariates of interest using individual level observations on time from the beginning of service in the AF to an event or non-event of suicide. We were committed from the beginning of the project to de-identifying all data to protect the privacy and confidentiality of all AF personnel before conducting any analyses. We included a number of independent predictors, covariates and time varying dependent variables. Construction of this complex database turned out to be a much greater challenge than we could have ever anticipated. Our time dependent variables include transitions such as deployment and redeployment as well as changes in an individual's life (e.g. age, occupation, marital status, a change in rank, or a change in location). Going into this project, we knew that ultimately the quality of the database would lie in our ability to (1) Obtain access to numerous AF and Department of Defense Data Sources; (2) Develop a secure process for de-identification of all individual level data and (3) Update critical transitions and changes on individual level on a quarterly basis. It took us the better part of four years to feel confident that we had produced a longitudinal, linked database that is secure, and protects the confidentiality and privacy of all Ar Force personnel. We also have a proven, experienced, well-integrated team that has accomplished this work together, and plans to pursue the next phase of this work together if it were to be funded. We are now extremely well poised to pursue the development of new methodological approaches in suicide research, utilizing this powerful and informative longitudinal data with a cohort that starts in 2003 and can be continually updated. We have accomplished our previous aims related to examining the relationship between the level of implementation of the Air Force Suicide Prevention Program across the entire service and have identified which components of the program appear to have the strongest effect (Knox KL, Pflanz S, Talcott GW, Campise RL, Lavigne JE, Bajorska A, Tu X, Caine ED. The Air Force Suicide Prevention Program: Implications for public health policy. American Journal of Public Health; [Epub ahead of print: May 13, 2010, 10.2105]). We have added data from multiple sources and have the opportunity in the future to utilize new data sources to enhance the database. We now are ideally poised to examine the effects and interactions of individual, community and organizational factors on the risk of suicide in the AF. We propose to do this through developing predictive models, using the implementation of new initiatives in the AF to reduce suicide. Key to these new initiatives is to increase resilience in AF personnel and early identification of high risk AF personnel, still delivered through the framework of a public health model of suicide prevention.

描述（由申请人提供）：2006 年，我们通过 1 R01 MH075017 获得资助，研究实施与美国空军 (AF) 自杀事件减少之间的关系。为了做到这一点，我们建议使用从 AF 服务开始到自杀事件或非事件期间的个人水平观察，将 AF 人事档案中的每个感兴趣的协变量链接到个人水平数据。我们从项目一开始就致力于在进行任何分析之前对所有数据进行去识别化处理，以保护所有 AF 人员的隐私和机密。我们纳入了许多独立预测变量、协变量和随时间变化的因变量。事实证明，构建这个复杂的数据库是一个比我们预想的更大的挑战。我们的时间相关变量包括部署和重新部署等转变以及个人生活的变化（例如年龄、职业、婚姻状况、级别变化或地点变化）。在进入这个项目时，我们知道数据库的质量最终取决于我们以下能力：(1) 访问大量空军和国防部数据源； (2) 制定一个安全流程，对所有个人级别的数据进行去识别化处理；(3) 每季度更新个人级别的关键转变和变更。我们花了四年的时间才确信我们已经创建了一个安全的纵向链接数据库，并保护所有 Ar Force 人员的机密和隐私。我们还拥有一支经过验证、经验丰富、整合良好的团队，他们共同完成了这项工作，并计划在获得资助的情况下共同开展下一阶段的工作。我们现在已经做好了充分的准备，利用这一强大且信息丰富的纵向数据以及从 2003 年开始并可以不断更新的队列数据，在自杀研究中寻求新的方法论方法的开发。我们已经完成了之前的目标，即检查整个军种中空军自杀预防计划的实施水平之间的关系，并确定了该计划的哪些组成部分似乎具有最强的效果（Knox KL、Pflanz S、Talcott GW、Campise RL、Lavigne JE、Bajorska A、Tu X、Caine ED。空军自杀预防计划：对公共卫生政策的影响。美国公众杂志 健康； [印刷前的电子版：2010 年 5 月 13 日，10.2105]）。我们添加了来自多个来源的数据，并且将来有机会利用新的数据源来增强数据库。我们现在已经准备好研究个人、社区和组织因素对 AF 自杀风险的影响和相互作用。我们建议通过开发预测模型、在 AF 中实施新举措来减少自杀来实现这一目标。这些新举措的关键是提高 AF 人员的复原力，并及早识别高风险 AF 人员，这仍然是通过预防自杀的公共卫生模型框架来实现的。