The Elders' Resilience Curriculum: Toward Building Empirical Evidence for a Culturally Grounded American Indian Youth Suicide Prevention Intervention

长者的复原力课程：为基于文化的美国印第安人青少年自杀预防干预建立经验证据

• 批准号: 10205974
• 负责人: Victoria O’Keefe
• 金额: $ 18.3万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10205974
• 关键词: Address; Adolescent; Adolescent Development; Affect; Age; Alaska Native; American Indians; Apache; Apache Tribe; Belief; Cessation of life; Cherokee Indian; Child; Clinical; Cognitive; Communities; Comprehension; Data; Development; Distal; Educational Curriculum; Educational process of instructing; Elderly; Evaluation; Family; Feeling suicidal; Focus Groups; Goals; Health; Healthcare; Indigenous; Individual; Intervention; Interview; K-Series Research Career Programs; Knowledge; Language; Life; Maps; Measurement; Measures; Mental Health; Mental Health Services; Mental health promotion; Mentored Research Scientist Development Award; Mentorship; Methods; Modeling; National Institute of Mental Health; Outcome; Participant; Personal Satisfaction; Prevention; Prevention Research; Program Evaluation; Public Health; Research; Research Methodology; Research Personnel; Research Support; Research Training; Resources; Review Literature; Risk; Risk Factors; Schools; Science; Specific qualifier value; Spirituality; Suicide; Suicide prevention; Testing; Theoretical model; Training; Tribal Elders; Tribes; Underserved Population; United States Substance Abuse and Mental Health Services Administration; White Mountain Apache; Work; Youth; acceptability and feasibility; base; career; community based participatory research; cost; cultural values; design; effectiveness study; experience; high risk; improved; innovation; native youth; prevent; preventive intervention; programs; protective factors; reducing suicide; resilience; response; scale up; suicidal behavior; suicidal risk; suicide mortality; theories; therapy design; tribal college; tribal community

PROJECT SUMMARY Suicide disproportionately affects American Indian/Alaska Native (AI/AN) communities, with the greatest burden experienced by AI/AN children and adolescents. A paucity of mental health care resources in AI/AN settings points to a critical need to deliver suicide prevention interventions outside conventional mental health clinical settings. Past research has shown cultural protective factor approaches will be more effective than risk- focused interventions to reduce AI/AN youth suicide. Culturally grounded (or “ground up”) prevention interventions—which place local culture and values at the forefront of intervention design, implementation, and evaluation—hold strong promise to prevent AI/AN youth suicide. However, we know little about core components, mechanisms, and constructs through which culturally grounded interventions can prevent suicide. The Elders’ Resilience Curriculum (ERC) is a school-based, culturally grounded, suicide prevention intervention currently delivered by White Mountain Apache Tribe (WMAT) Elders through monthly lessons about tribal cultural values, beliefs, ways of life, and Apache language to youth ages 9-14, a nascent stage prior to the highest risk period for suicide (15-24 years old) in this community. The proposed research builds upon the Johns Hopkins Center for American Indian Health and WMAT’s 35+ year research and public health partnership that continues to innovate and scale prevention interventions through community-based participatory research. The candidate will engage with the tribal-university partners to conduct an Exploratory Sequential Mixed Methods study to identify key suicide protective factors and ERC core components that target these factors, refine a theoretical model specifying causal mechanisms and outcomes, develop a culturally adapted assessment battery, and pilot a rigorous evaluation to test the theoretical model and culturally adapted measures to prepare for a larger R01 effectiveness study. If successful, new understanding of the mechanisms and constructs through which ERC operates to prevent AI/AN youth suicide will support replication and scaling of this intervention to other AI/AN communities suffering youth suicide disparities. The proposed K01 will provide the candidate, who is from the Cherokee/Seminole Nations, with critical training in qualitative and mixed methods research, culturally grounded intervention design and evaluation, and child/adolescent development as it relates to resiliency, cultural identity, and suicide prevention. The candidate will receive guidance and targeted training from a mentorship team of national experts at the forefront of Indigenous mental health prevention science. This K01 award will support her to become an Indigenous NIMH independent investigator focused on culturally-informed, strengths-based mental health promotion research. The proposed research and candidate’s career goals align with NIMH Strategic Objective 4 to “strengthen the public health impact of NIMH-supported research” and “identify, validate, and scale-up innovative programs currently in use that improve mental health services for underserved populations” (4.1).

项目概要 自杀对美洲印第安人/阿拉斯加原住民 (AI/AN) 社区的影响尤为严重，其中影响最大的是 AI/AN 儿童和青少年所经历的负担。 AI/AN 中精神卫生保健资源匮乏 环境表明迫切需要在传统心理健康之外提供自杀预防干预措施 临床环境。过去的研究表明，文化保护因素方法比风险方法更有效。 重点干预措施以减少 AI/AN 青少年自杀。基于文化（或“基础”）的预防 干预措施——将当地文化和价值观置于干预措施设计、实施和实施的最前沿 评估——坚定承诺防止 AI/AN 青少年自杀。然而我们对核心知之甚少 基于文化的干预措施可以预防自杀的组成部分、机制和结构。 长者复原力课程 (ERC) 是一项以学校为基础、以文化为基础的自杀预防课程 目前由白山阿帕奇部落 (WMAT) 长老通过每月课程进行干预 向 9 至 14 岁的青少年（新生阶段）介绍部落文化价值观、信仰、生活方式和阿帕奇语言 在该社区的自杀最高风险期（15-24 岁）之前。拟议的研究构建 基于约翰·霍普金斯美洲印第安人健康中心和 WMAT 35 年以上的研究和公共卫生 通过基于社区的合作伙伴关系不断创新和扩大预防干预措施 参与式研究。候选人将与部落大学合作伙伴合作进行探索性研究 序贯混合方法研究以确定关键的自杀保护因素和 ERC 核心组成部分 针对这些因素，完善指定因果机制和结果的理论模型，开发 适应文化的评估电池，并试点严格的评估来测试理论模型和 采取适应文化的措施，为更大规模的 R01 有效性研究做准备。如果成功的话，会有新的认识 ERC 预防 AI/AN 青少年自杀的机制和结构将支持 将这种干预措施复制并推广到其他遭受青少年自杀差异的 AI/AN 社区。这 拟议的 K01 将为来自切罗基/塞米诺尔民族的候选人提供关键培训 定性和混合方法研究、基于文化的干预设计和评估，以及 儿童/青少年的发展，因为它与弹性、文化认同和自杀预防有关。候选人 将接受国家前沿专家导师团队的指导和针对性培训 土著心理健康预防科学。该 K01 奖项将支持她成为一名土著 NIMH 独立调查员专注于基于文化、基于优势的心理健康促进研究。 拟议的研究和候选人的职业目标与 NIMH 战略目标 4 一致，即“加强 NIMH 支持的研究对公共卫生的影响”和“识别、验证和扩大创新项目 目前正在使用改善服务不足人群的心理健康服务”（4.1）。