Promoting Community Conversations about Research to end Native Youth Suicide in Rural Alaska

促进关于结束阿拉斯加农村土著青少年自杀研究的社区对话

• 批准号: 10363684
• 负责人: Lisa M. Wexler
• 金额: $ 57.23万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-19 至 2024-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10363684
• 关键词: Acute; Affect; Age; Air; Alaska; Alaska Native; American; Attitude; Behavior; Caring; Characteristics; Collaborations; Communities; Community Practice; Community Workers; Diffusion; Distress; Educational Intervention; Effectiveness; Elderly; Event; Family; Family member; Friends; Goals; Growth; Guns; Health; Health Educators; Health Knowledge Attitudes Practice; Health Personnel; Health Promotion; Healthcare; Home; Hospitals; Hour; Human Resources; Indigenous; Individual; Intervention; Interview; Jail; Knowledge; Learning; Measurement; Measures; Mental Health; Mental Health Services; Mentors; Methods; Modeling; Occupations; Outcome; Parents; Participant; Pattern; Personal Satisfaction; Persons; Pilot Projects; Plague; Positioning Attribute; Predictive Factor; Prevention; Prevention Research; Primary Prevention; Protocols documentation; Provider; Reporting; Research; Research Methodology; Resources; Risk; Risk Assessment; Risk Factors; Risk Reduction; Role; Rural; Safety; Schools; Science; Secondary Prevention; Series; Social Network; Social support; Stream; Suicide; Suicide prevention; Support System; Surveys; Testing; Time; Training; Translating; Variant; Work; Youth; age group; base; care systems; community based care; community based participatory research; community intervention; community organizations; dosage; experience; follow-up; grandparent; health disparity; help-seeking behavior; indigenous community; innovation; member; native youth; pedagogy; peer; post intervention; prevent; reducing suicide; rural Alaska; service providers; skills; social; suicidal; suicidal behavior; suicidal risk; suicide rate; teacher; working group

With rates up to 18 times higher for rural Alaska Native (AN) young people when compared to all American youth (124 vs 6.9 per 100,000), the health disparity of youth suicide continues to plague rural Indigenous communities in Alaska. The current system of care—with a focus on mental health—is not effective: 79% of suicide decedents and 62% of attempters received NO mental health care. Vulnerable AN youth are more likely to come into contact with healthcare providers, school personnel, public safety workers, and other community members. Additionally, friends and family members noticed signs of risk beforehand in 62% of all recorded suicidal behavior. These villagers can offer culturally-specific social support and safety measures to avert a suicide crisis, but they are not trained to initiate primary and secondary prevention. Currently, three times out of four, community members mobilize only when the person is in `imminent risk' of suicide. This level of risk means that vulnerable AN youth are taken 500 air miles away for assessment in a confined hospital room many associate with `jail'. After this experience, most AN youth return home less likely to seek help the next time they feel suicidal. Late intervention cuts off options for cultural, family and community-based care, which is preferred by AN youth and their families. To initiate activities to promote wellness, safety and support before a suicide crisis, our tribal working group developed and piloted PC CARES: Promoting Community Conversations About Research to End Suicide. This promising and feasible educational intervention is led by local facilitators, and offers village stakeholders a series of learning circles to study `what we know' from prevention research and figure out how they can apply it to their jobs, families, and lives. The goal of the intervention is to enhance knowledge, skills and attitudes among service providers, family members and tribal residents so that they promote wellbeing, recognize risk, support vulnerable youth, and work with others in their community to take supportive and safety actions when they notice signs of vulnerability. Our community intervention utilizes indigenous pedagogy and prevention science to increase village members' and service providers' capacity to find `up-stream', self-determined and culturally-responsive ways to reduce suicide risk. Using a community-based, participatory research (CBPR) approach, our specific aims track change on both individual and community levels. Aim 1: Track the effect of PC CARES on participants' knowledge, attitudes and behavior, and identify key factors influencing these outcomes over time. Aim 2: Document the community-level impact of PC CARES by tracking the number and type of interactions aimed at preventing youth suicide and promoting wellness in participating villages, and describe changes in the supportive social networks of young people before and after the intervention. IMPACT: Our scalable model offers under-resourced Native communities a practical method for translating scientific research into culturally relevant efforts to reduce suicide risk factors, and increase safety, help-seeking and support to prevent suicide.

与所有美国人相比 青年（124 vs 6.9每100,000），青年自杀的健康差异继续困扰着粗糙的土著 阿拉斯加的社区。当前的护理系统（关注心理健康）无效：79％ 自杀决定，有62％的人没有获得精神卫生保健。脆弱的年轻人更多 可能与医疗保健提供者，学校人员，公共安全工作人员和其他 社区成员。此外，朋友和家人事先注意到了62％的风险迹象 记录自杀行为。这些村民可以提供特定于文化的社会支持和安全措施 避免自杀危机，但没有受过训练来发起初级和次要预防。目前，三个 在四分之一的时代，社区成员只有在此人处于自杀的“迫在眉睫的风险”中时动员。这 风险水平意味着脆弱的年轻人被带到500英里以外的空气中进行评估 病房许多与“监狱”联系在一起。经历了这一经历，大多数年轻人返回家中都不太可能寻求 下次他们感到自杀时帮助他们。晚期干预切断了基于文化，家庭和社区的选择 护理，这是青年及其家人的首选。发起活动以促进健康，安全和 自杀危机之前的支持，我们的部落工作组开发并试行PC护理：促进 关于结束自杀的研究的社区对话。这种有希望和可行的教育 干预由当地的促进者领导，并为乡村利益相关者提供一系列学习电路来研究什么 我们从预防研究中知道，并弄清楚他们如何将其应用于自己的工作，家庭和生活。这 干预的目标是增强服务提供商，家庭成员的知识，技能和参加 和部落居民，使他们促进福祉，认识风险，支持弱势青年并与之合作 当他们社区中的其他人注意到脆弱性的迹象时，他们会采取支持和安全行动。我们的 社区干预利用土著教学法和预防科学来增加乡村成员的成员和 服务提供商找到“上流传输”，自决和文化响应的方式来减少的能力 自杀风险。使用基于社区的参与研究（CBPR）方法，我们的具体目标跟踪 改变个人和社区层面。目标1：跟踪PC护理对参与者的影响 知识，参加和行为，并确定影响这些结果随着时间的关键因素。目标2： 通过跟踪针对的互动数量和类型来记录PC护理的社区级别影响 防止青年自杀并促进参与村庄的健康，并描述 干预前后的年轻人的支持性社交网络。影响：我们的可扩展模型 提供资源不足的土著社区一种实用方法，可以将科学研究转化为文化 减少自杀危险因素，增加安全性，寻求帮助和支持以防止自杀的相关努力。

项目成果

Beyond two worlds: Identity narratives and the aspirational futures of Alaska Native youth.

超越两个世界：阿拉斯加原住民青年的身份叙事和理想的未来。

• DOI: 10.1177/1363461518786991
• 发表时间: 2018
• 期刊: Transcultural psychiatry
• 影响因子: 2.5
• 作者: Trout,Lucas;Wexler,Lisa;Moses,Joshua
• 通讯作者: Moses,Joshua

Considering the importance of 'Communities of Practice' and Health Promotion Constructs for Upstream Suicide Prevention.

考虑“实践社区”和健康促进结构对于上游自杀预防的重要性。

• DOI: 10.21203/rs.3.rs-3976483/v1
• 发表时间: 2024
• 期刊: Research square
• 作者: Wexler,Lisa;Ginn,Joel;White,Lauren;Schmidt,Tara;Rataj,Suzanne;Wells,CarolineC;Schultz,Katie;Kapoulea,EleniA;McEachern,Diane;Habecker,Patrick;Laws,Holly
• 通讯作者: Laws,Holly

Suicide Postvention in Schools: What Evidence Supports Our Current National Recommendations?

学校预防自杀：哪些证据支持我们目前的国家建议？

• 发表时间: 2022
• 期刊: School social work journal
• 作者: Williams,DeniseYookong;Wexler,Lisa;Mueller,AnnaS
• 通讯作者: Mueller,AnnaS

Arctic Suicide, Social Medicine, and the Purview of Care in Global Mental Health.

北极自杀、社会医学和全球心理健康护理范围。

• 发表时间: 2020
• 期刊: Health and human rights
• 影响因子: 3.7
• 作者: Trout,Lucas;Wexler,Lisa
• 通讯作者: Wexler,Lisa

Implementation beyond the clinic: Community-driven utilization of research evidence from PC CARES, a suicide prevention program.

• DOI: 10.1002/ajcp.12609
• 发表时间: 2022-12
• 期刊: AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY
• 影响因子: 3.1
• 作者: White, Lauren A.;Wexler, Lisa;Weaver, Addie;Moto, Roberta;Kirk, Tanya;Rataj, Suzanne;Trout, Lucas;McEachern, Diane
• 通讯作者: McEachern, Diane