Innovations in Suicide Prevention Research (INSPIRE)

自杀预防研究的创新（INSPIRE）

• 批准号: 10842092
• 负责人: Brian W Pence
• 金额: $ 6.7万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-09 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10842092
• 关键词: Address; Adolescent; Age; Benchmarking; Caring; Cessation of life; Clinic; Clinical; Data; Data Linkages; Data Set; Databases; Death Records; Economics; Emotional; Epidemic; Epidemiologic Methods; Evaluation; Future; General Population; Health Insurance; Health Services Accessibility; Health system; Healthcare; Healthcare Systems; Hospitals; Imprisonment; Incidence; Individual; Inpatients; Insurance; Insurance Carriers; Integrated Health Care Systems; Interruption; Link; Long-Term Care; Machine Learning; Medicaid; Mental Health; Methodology; Monitor; North Carolina; Outcome; Patients; Pattern; Persons; Policies; Population; Positioning Attribute; Prevention; Prevention Measures; Prevention Research; Prisons; Privatization; Protocols documentation; Provider; Recording of previous events; Records; Registries; Reporting; Research; Research Design; Risk; Risk Assessment; Sampling; Security Measures; Suicide; Suicide attempt; Suicide prevention; System; Target Populations; Time Series Analysis; United States; Update; Violence; Vulnerable Populations; Work; Youth; case control; clinical predictors; correctional system; cost; density; design; experience; health care availability; health care service utilization; high risk; innovation; insurance claims; mortality; mortality risk; patient population; population based; predictive tools; prevention evaluation; preventive intervention; prospective; risk prediction; screening; study population; suicidal morbidity; suicidal risk; suicide mortality; tool; years of life lost; young adult

ABSTRACT Despite intensive prevention efforts from federal and state agencies, suicide is now the 10th leading cause of mortality overall in the US, increasing steadily over the past two decades and claiming more than 47,000 lives in 2017. The impact of suicide is particularly high among vulnerable populations such as adolescents and formerly incarcerated individuals. Suicide attempts also exact a high emotional, physical, and economic toll. Although much research has focused on causes and predictors of death from suicide, progress in suicide prevention has been hampered by data linkage and methodological challenges. While national mortality rates are known, entities with the potential to implement large suicide prevention initiatives – health systems, insurers, and departments of corrections – lack the linked data to monitor suicide incidence in their populations, establish benchmarks, and establish an evaluation framework for prevention efforts. Many individuals who die from suicide have had recent contact with a health care, health insurance, or correctional system, representing critical missed opportunities to implement suicide prevention measures. Two key needs are highlighted by the present RFA: linked surveillance systems that integrate healthcare, insurer (private and public), and correctional data with mortality outcomes to provide a framework for implementing and evaluating suicide prevention initiatives, and large and adequately powered datasets with rich health care access information over an extended period, matched with rigorous study designs for observational data. Therefore, our objective in the current proposal is to establish an in-depth suicide surveillance system linking multiple large, comprehensive databases and use that system to define suicide mortality benchmarks, identify predictors of suicide risk, generate risk prediction tools, evaluate suicide prevention efforts, and establish long-term workflow protocols to sustain the surveillance system. Our team is uniquely positioned to address these needs through our deep expertise in suicide, mental health, and health care utilization research; our extensive experience in application of rigorous epidemiological methods to large linked databases; our established access to comprehensive, regularly updated databases representing health care encounters, public and private insurance claims, corrections data, and suicide deaths in one of the most populous states in the US; and our successful work in prior projects to link all of these databases at the individual level using all appropriate safeguards and security measures. This project will be the first to link these large state- and healthcare system-level databases to establish an ongoing suicide surveillance system to identify short and long term predictors of suicide and to inform and evaluate suicide prevention efforts in North Carolina and across the United States. We anticipate such suicide prevention efforts will get embedded in healthcare systems where at-risk individuals can be identified and referred for prevention and care, thereby preventing suicides and reducing their societal impacts.

抽象的 尽管联邦和州机构进行了密集的预防努力，但自杀现已成为第十个主要原因 整体死亡率在美国，在过去的二十年中越来越安静，声称超过47,000 生活在2017年。自杀的影响在青少年和 以前被监禁的个体。自杀企图也是一个高度的情感，身体和经济损失。 尽管许多研究集中在自杀的原因和死亡的预测因素上，但自杀的进展 数据链接和方法论挑战阻碍了预防。而国家死亡率 众所周知，具有实施大型自杀预防计划的实体 - 卫生系统， 确保和部门的矫正 - 缺乏链接的数据来监视其自杀事件 人群，建立基准并建立预防工作的评估框架。许多 死于自杀的人最近与医疗保健，健康保险或纠正措施联系 系统，代表着重要的失踪机会来实施自杀预防措施。 目前的RFA强调了两个关键需求：整合医疗保健的链接监视系统， 保险公司（私人和公共），以及具有死亡率结果的纠正性数据，为 实施和评估预防自杀计划，以及大型且功能齐全的数据集 丰富的医疗保健访问信息在很长的一段时间内与严格的研究设计相匹配 观察数据。因此，我们在当前提案中的目标是建立深入的自杀 监视系统链接多个大型，全面的数据库，并使用该系统定义自杀 死亡率基准，确定自杀风险的预测因素，产生风险预测工具，评估自杀 预防工作，并建立长期工作流程协议以维持监视系统。我们的团队是 通过我们在自杀，心理健康和健康方面的深厚专业知识来满足这些需求的独特位置 护理利用研究；我们在严格的流行病学方法中应用大型的丰富经验 链接数据库；我们已建立的代表健康的综合，定期更新的数据库访问 医疗遭遇，公共和私人保险索赔，更正数据和自杀死亡人数最多 美国人口众多的国家；以及我们在以前的项目中成功的工作，将所有这些数据库链接在 使用所有适当的保障措施和安全措施的个人级别。 该项目将是第一个链接这些大型州和医疗保健系统级数据库的项目 正在进行的自杀监视系统识别自杀的短期和长期预测因素，并告知和 评估北卡罗来纳州和整个美国的自杀预防工作。我们期待这种自杀 预防工作将嵌入到可以确定高危个人的医疗保健系统中，并且 转介预防和护理，从而防止自杀并减少其社会影响。

项目成果

Innovations in suicide prevention research (INSPIRE): a protocol for a population-based case-control study.

自杀预防研究的创新（INSPIRE）：基于人群的病例对照研究方案。

• DOI: 10.1136/injuryprev-2022-044609
• 发表时间: 2022
• 期刊: Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
• 作者: Ranapurwala,ShabbarI;Miller,VanessaE;Carey,TimothyS;Gaynes,BradleyN;Keil,AlexanderP;Fitch,CatherineVinita;Swilley-Martinez,MonicaE;Kavee,AndrewL;Cooper,Toska;Dorris,Samantha;Goldston,DavidB;Peiper,LewisJ;Pence,BrianW
• 通讯作者: Pence,BrianW

Hurricane Florence and suicide mortality in North Carolina: a controlled interrupted time-series analysis.

• DOI: 10.1136/ip-2022-044709
• 发表时间: 2023-04
• 期刊: INJURY PREVENTION
• 影响因子: 3.7
• 作者: Miller, Vanessa Eve;Pence, Brian W.;Fitch, Kate Vinita;Swilley-Martinez, Monica;Kavee, Andrew L.;Dorris, Samantha;Cooper, Toska;Keil, Alexander P.;Gaynes, Bradley N.;Carey, Timothy S.;Goldston, David;Ranapurwala, Shabbar
• 通讯作者: Ranapurwala, Shabbar