Components of Effective Suicide Prevention in the USAF

描述（由申请人提供）：本申请首先是对实施与减少自杀事件之间关系的研究。1997年，美国空军全面实施了一项复杂的、多方面的自杀预防计划。因此，美国空军提供了一个良好的环境，可以研究多方面计划的哪些组成部分最有效地产生预期的结果。虽然人们对实施在决定项目有效性方面所起的作用的兴趣激增，但专门调查实施与预防和/或干预结果之间关系的实证研究相对较少。在这项研究中，我们定义了空军自杀预防计划（AFSPP）的五个核心功能组成部分，这些组成部分基于自该计划成立以来构成该计划的11项倡议。然而，我们目前对AFSPP有效性的理解仅限于该计划的明显成功，该计划基于对这11项倡议的实施与自杀事件和其他相关结果下降之间的时间关联的非特异性理解。由于几个相关的原因，在这个时候进行这项研究很重要。首先，空军正在进行的项目工作将大大受益于对一个非常复杂、多方面的项目的功能组成部分的更具体的理解。其次，将AFSPP复制到新的环境中可能具有巨大的科学价值。空军的项目有着良好的记录，是为数不多的以社区为基础的自杀预防项目之一，在人口众多的情况下，这可能被证明是为科学服务的典范。作为美国人口的一个样本，空军是由一个健康的开放队列组成的，这有助于减少在使用临床或精神病学样本进行自杀研究时固有的选择偏差。因此，我们的研究结果可能对其他相对健康的人群有重要意义，包括大学生和中年男性和女性。然而，关于如何最好地将不同地点对保真度的感知需求与足够的灵活性结合起来，从而使具有不同人口特征和文化规范的社区成功参与，这是一个尚未解决但正在进行的争论。如果我们能够更好地了解AFSPP的哪些核心组成部分可以灵活地跨位点翻译，同时保持与这些组成部分相关的完整功能，那么本研究的数据将对一般心理健康预防领域具有重要意义。

DESCRIPTION (provided by applicant): This application is first and foremost a study of the relationship between implementation and reductions in events of suicide. In 1997, the United States Air Force had fully implemented a complex, multifaceted suicide prevention program. As such, the United States Air Force provides an excellent environment in which to study which components of a multifaceted program are most effective in producing the desired outcomes. While there has been a surge of interest in the role that implementation plays in determining the effectiveness of a program, there are relatively few empirical studies that specifically investigate the relationship between implementation and prevention and/or intervention outcomes. For this study, we have defined five core, functional components of the Air Force Suicide Prevention Program (AFSPP) based on the Eleven Initiatives that have constituted the program since its inception. However, our current understanding of the effectiveness of the AFSPP has been limited to the apparent success of the program based on a nonspecific understanding of the temporal association between implementation of these Eleven Initiatives and declines in events of suicide and other related outcomes. Conducting this study at this time is important for several related reasons. First, on-going programmatic efforts in the Air Force will greatly benefit from attaining a more concrete understanding of the functional components of what has been a very complex, multifaceted program. Second, replication of the AFSPP to new settings is potentially of great scientific value. The Air Force has a good track record with its program, is one of the few community based programs for suicide prevention in a very large population, and may prove to be an exemplary model of service to science. As a sample of the U.S. population the Air Force is comprised of a healthy open cohort, which serves to reduce the selection bias inherent in studies of suicide that utilize clinical or psychiatric samples. As such, our findings may be significant for other relatively healthy populations, including college students and men and women in the middle years of life. However, there is an unresolved but on-going debate about how best to combine the perceived need for fidelity across different sites with sufficient flexibility that permits successful engagement with communities with diverse demographic characteristics and cultural norms. The data from this study will have great significance for the field of mental health prevention in general if we can reach a greater appreciation for which of the core components of the AFSPP can be flexibly translated across sites, while at the same time maintaining the full functionality associated with those components.