Expanding the Geospatial Identification of Elevated Suicide Risk (GIESR) Method to Identify Neighborhood Level Risk and Protective Factors for Youth Suicide Ideation and Attempts

项目总结 自杀是美国青少年死亡的第二大原因。34国家战略 预防自杀呼吁发展社区预防服务，以降低自杀风险 对于自杀行为来说，1然而，我们对社区层面相关变量的了解存在很大差距 2开发社区自杀预防方法的关键下一步是 确定用于公共卫生干预的可修改的目标机制。我们的目标是 建议确定与自杀风险有关的可修改的候选机制 居民区水平。我们的团队已经提出并研究了一种识别局部地区的统计方法 随着社区内自杀念头和自杀企图的增加， 自杀风险升高(GIESR)方法。GIESR方法利用常规的自杀风险筛查 在医疗保健环境中进行。GIESR利用电子健康记录数据绘制出 在确定的地理集水区内有自杀念头和企图。对GIESR的进一步评估 模型，以复制和推广这一方法论方法，将支持确定 青少年自杀意念与企图的邻里层面风险与保护因素。 该项目有两个主要目标：目标1将复制和扩展GIESR方法以评估其 心理测量学属性，并创建实施指南，以便GIESR可以独立复制 并被其他人用来开发基于社区的自杀预防计划。GIESR方法 将使用德克萨斯儿童医院的数据进行检查，并绘制出年轻人自杀风险较大的 休斯顿大都市区。在目标2中，我们将应用GIESR方法来识别风险和保护因素 与邻里层面的青少年自杀意念和企图的比率有关。目标2包括 合并多个以公共健康为重点的数据集，包括社会经济、犯罪和安全数据，以及 利用空间制图数据和GIESR生成的数据，允许识别突出风险和保护 社区层面的自杀因素。 这项提议推进了NIMH战略计划的目标4，战略4.1，利用“电子健康” 记录…确定改进服务获取、交付和结果的可变目标“，并促进数据- 确定预防性干预的新目标的驱动方法。33调查结果将为GIESR的使用提供信息 确定其他社区风险升高的地区的方法，并将为社区的发展提供信息- 以已确定的风险和保护因素为目标的自杀预防努力。

PROJECT SUMMARY Suicide is the second leading cause of death among adolescents in the United States.34 The National Strategy for Suicide Prevention calls for the development of community preventive services that will reduce the risk for suicidal behaviors.1 Yet there is a substantial gap in our knowledge of community level variables associated with suicide risk.2 A critical next step toward developing community suicide prevention approaches is the identification of modifiable target mechanisms for use in public health interventions. Our objective in this proposal is to identify modifiable candidate mechanisms associated with suicide risk at the neighborhood level. Our team has proposed and examined a statistical method for identifying localized areas with elevated rates of suicidal ideation and attempts within the community, the Geospatial Identification of Elevated Suicide Risk (GIESR) method. The GIESR method capitalizes on routine suicide risk screening conducted within healthcare settings. GIESR draws on electronic health records data to map the prevalence of suicide ideation and attempts within a defined geographic catchment area. Further evaluation of the GIESR model, to replicate and extend this methodological approach, will support the identification of neighborhood level risk and protective factors for youth suicidal ideation and attempts. The project has two primary aims: Aim 1 will replicate and extend the GIESR method to evaluate its psychometric properties and to create an implementation guide, so that GIESR can be independently replicated and used by others for the development of community-based suicide prevention programs. The GIESR method will be examined using data from Texas Children’s Hospital and mapping youth suicide risk within the greater Houston metropolitan area. In Aim 2, we will apply the GIESR method to identify risk and protective factors associated with rates of youth suicide ideation and attempts at the neighborhood level. Aim 2 includes the merging of multiple public health focused data sets, including socioeconomic, crime, and safety data, along with spatial mapping data and data generated by GIESR, to allow the identification of salient risk and protective factors for suicide at the community level. This proposal advances the goals of the NIMH Strategic Plan, Goal 4, Strategy 4.1, to utilize “electronic health records… to identify mutable targets for improving service access, delivery, and outcomes” and to promote data- driven approaches to identify novel targets for preventive interventions.33 Findings will inform use of the GIESR method to identify areas of elevated risk in other communities and will inform the development of community- based suicide prevention efforts targeting identified risk and protective factors.