Cultural Consensus Modeling to Identify Culturally Relevant Risk Factors for Suicide among Black Youth

文化共识模型识别黑人青年自杀的文化相关风险因素

• 批准号: 10681432
• 负责人: Jennifer L Brown
• 金额: $ 20.45万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10681432
• 关键词: Adult; Age; Belief; Black race; Client; Consensus; Death Rate; Dropout; Empirical Research; Ethnography; Feeling suicidal; Female; Future; Gender; Heterogeneity; Individual; Individual Differences; Intervention; Interview; Knowledge; Maps; Measures; Mental Depression; Mental Health; Mental Health Services; Methodology; Methods; Modeling; Motivation; Nature; Participant; Phase; Population; Prevention program; Process; Property; Psychiatry; Psychological Theory; Psychometrics; Public Health; Questionnaires; Research; Research Personnel; Risk; Risk Factors; Sampling; Severities; Structural Racism; Subgroup; Suicide; Suicide attempt; Suicide prevention; Testing; Theoretical model; Time; Voice; Work; Youth; career; evidence base; expectation; experience; informant; intersectionality; intervention program; lens; peer; predictive modeling; public health relevance; racial discrimination; recruit; research and development; response; social; suicidal behavior; suicidal morbidity; suicidal risk; theories; therapy development

ABSTRACT Between 1991 and 2017 there was a 73% increase in suicide attempts among Black youth. Black youth <13 are twice as likely to die by suicide compared to White peers. Theoretical models (e.g. Interpersonal-Psychological Theory of Suicide; IPTS) and the interventions they inform have largely utilized non-Black, non-youth, samples, limiting their relevance for Black youth. Our team, which include two Black early career researchers will be the first to make use of a rigorous, multi-method, ethnographic approach, namely Cultural Consensus Modeling (CCM), to give direct voice to the reasons for suicidal thoughts and behaviors in Black youth, ages 11-17, in the form of cultural models generated by Black youth themselves. We will then evaluate cultural models for their association with more traditional suicide predictors derived from IPTS (perceived burdensomeness, thwarted belongingness, acquired capability), in addition to variables related to social injustice, in particular racial discrimination. Guided by a conceptual framework that integrates IPTS and Intersectionality, our central hypothesis is that derived cultural models will point to the importance of redefining IPTS variables through the lens of racial discrimination. The CCM methodology is iterative in nature with initial study phases informing subsequent phases, verifying and further testing derived cultural models. Aim 1 will recruit 50 at-risk Black youth (50% female), as determined by past suicidal ideation or behaviors and moderate-severe depression scores. Making use of “free listing” CCM methodology, youth will be asked to identify risk factors (common reasons) for suicidal thoughts and behaviors among peer Black youth. We hypothesize that Black youth will generate IPTS-related motivations for suicide as well as motivations related to racial discrimination. Aim 2 will recruit a new sample of 100 at-risk Black youth (50% female) who will rate the culture-relevance of factors generated in Aim 1 on a 5-point likert scale. We hypothesize that more than one cultural consensus model (clusters) will emerge given expected heterogeneity (sub-cultures) in the population. Aim 3 will utilize a subset of participants (N=25; 50% female) who completed Aim 2 to represent each identified cultural model from Aim 1. Qualitative interviews will be conducted to gather in-depth information on each cultural model. Informed by the results of Aims 1-3, Aim 4 will recruit a new sample of 200 at-risk Black youth (50% female), alongside measures of IPTS and racial discrimination to test the hypotheses that (1) cultural models will map well onto own reasons for suicidal thoughts and behaviors; (2) cultural models will align with individual differences in IPTS and racial discrimination, and that (3) models that align with racial discrimination will most strongly predict suicide severity, pointing to the importance of redefining IPTS variables through the lens of racial discrimination. The proposed work responds to urgent calls for research on the risk factors for suicidal behaviors in Black youth and will, for the first time, provide empirically derived treatment targets for culturally relevant treatment adaptation of IPTS and other suicide prevention programs.

摘要 1991年至2017年间，黑人青年的自杀企图增加了73%。黑人青年和13人是 与白人同龄人相比，自杀死亡的可能性是白人的两倍。理论模型(例如人际-心理学 自杀理论；IPTS)和它们所提供的干预措施主要利用了非黑人、非青年、样本、 限制了他们与黑人青年的相关性。我们的团队，包括两名黑人早期职业研究人员将是 首先使用一种严格的、多种方法的人种学方法，即文化共识建模 (CCM)，直接表达11-17岁黑人青年自杀想法和行为的原因 黑人青年自身所产生的文化模式的形式。然后我们将评估文化模式 它们与来自IPTS的更传统的自杀预测指标(感知的负担， 受挫的归属感、获得的能力)，以及与社会不公正有关的变量，特别是 种族歧视。在综合了信息技术和交叉性的概念框架的指导下，我们的中央 假设派生的文化模型将指出重新定义IPTS变量的重要性 种族歧视的镜头。CCM方法本质上是迭代的，最初的研究阶段提供信息 后续阶段，验证和进一步测试派生的文化模型。AIM 1将招募50名高危黑人 青年(50%女性)，由既往自杀想法或行为和中-重度抑郁症决定 得分。利用“免费列出”的CCM方法，青少年将被要求识别危险因素(常见的 原因)同龄人黑人青年中的自杀想法和行为。我们假设黑人青年会 产生与IPTS有关的自杀动机以及与种族歧视有关的动机。目标2将 招募100名高危黑人青年(50%女性)的新样本，他们将对各种因素的文化相关性进行评级 在目标1中以5分的利克特量表生成。我们假设不止一种文化共识模式 (集群)将在种群中出现预期的异质性(亚文化)。目标3将利用一个子集 完成目标2的参与者(N=25；50%女性)代表AIM确定的每一种文化模式 1.将进行定性访谈，以收集关于每种文化模式的深入信息。通知人 目标1-3的结果，目标4将招募新的样本 200个 高危黑人青年(50%女性)，以及 IPTS和种族歧视的测量，以检验以下假设：(1)文化模型将很好地映射到 自杀想法和行为的原因；(2)文化模式将与个体差异相一致 IPTS和种族歧视，以及(3)与种族歧视相一致的模型将最有力地预测 自杀严重性，指出通过种族视角重新定义IPTS变量的重要性 歧视。这项拟议的工作响应了对自杀风险因素进行研究的迫切要求 黑人青年的行为，并将首次为文化上的治疗提供经验派生的目标 IPTS和其他自杀预防方案的相关治疗适应。