Synthesis of Trials to Prevent Suicide Risk Behavior in Sexual and Gender Minorities

预防性少数群体自杀危险行为的试验综述

• 批准号: 9593991
• 负责人: C. HENDRICKS BROWN
• 金额: $ 51.93万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-06 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9593991
• 关键词: 19 year old; Adolescent; Alcohol abuse; Alcohol consumption; Anxiety; Authorization documentation; Behavior; Cause of Death; Characteristics; Coupled; Data; Data Analyses; Data Science; Data Set; Development; Disease; Distal; Drug abuse; Drug usage; Family member; Feeling suicidal; Female; Friends; Gender; General Population; Individual; Interpersonal Violence; Intervention; Intervention Trial; Measurement; Measures; Mental Depression; Mental Health; Methodology; Methods; Minority; Outcome; Outcome Measure; Participant; Population Research; Populations at Risk; Prevalence; Prevention; Prevention program; Prevention trial; Preventive; Preventive Intervention; Psychometrics; Public Health; Randomized; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Sampling; Science Policy; Self-Injurious Behavior; Sexual and Gender Minorities; Shock; Subgroup; Suicide; Suicide attempt; Suicide prevention; Surveys; Symptoms; Testing; Time; United States; United States National Institutes of Health; Violence; Work; Youth; adolescent health outcomes; adolescent suicide; base; behavioral health; bullying; comparative; experience; externalizing behavior; gender minority; high risk; high school; improved; indexing; intervention effect; male; next generation; prevent; programs; randomized trial; reducing suicide; sexual minority; suicidal behavior; suicidal risk; suicide rate; trend; trial design; virtual

Sexual and gender minority (SGM) youth have annual prevalence rates of suicide attempts of 29%, up to 4.6 times higher than that of other youth. We propose to test whether prevention programs that target suicide directly, or a range of factors that increase risk for suicide (internalizing symptoms, alcohol abuse, drug use, externalizing, bullying and interpersonal violence) reduce suicide risk for youth in general, and whether SGM youth benefit more or less from such programs. Working with a broad network of prevention trials researchers, we have received permission to obtain individual-level data from 21 randomized prevention trials involving 100,851 participants. All trials include direct or surrogate measures of suicide risk, and information about SGM status. Although all trials have tested and reported intervention impact on specific behavioral health outcomes, few have tested specific impact on SGM youth, given that such youth make up a relatively small proportion of the samples in each study. Our work and that of others indicates that combining data across trials will provide far greater power for testing several key hypotheses about impact on suicide risk, and whether SGM youth receive differential benefit from these interventions. We will use methods developed in our prior work to combine these datasets, and utilize findings from two measurement development studies of SGM and non-SGM youth suicide risk to guide advanced psychometric analyses for harmonizing outcome measures and developing a common index of suicide risk. We will apply integrative data analysis (IDA) methods that account for missing data to test three sets of hypotheses. Aim 1. Test whether different types of interventions decrease risk for suicidal thought and behavior among youth in the general population. We hypothesize that preventive programs reduce risk for suicidality regardless of primary target. We will use IDA to test this hypothesis on 21 trials (n=100,851). Aim 2. Test whether preventive effects differ for SGM youth. Given the unique risks often faced by SGM youth, we hypothesize that prevention programs will reduce risk for suicidality for SGM youth, but will be less effective compared with other youth. We will test moderation on 5,232 SGM and 95,619 non-SGM youth. Aim 3. Test whether preventive effects on SGM youth vary by type of intervention. We hypothesize that interventions targeting bullying and internalizing symptoms will be more effective in reducing suicide risk for SGM youth compared with interventions targeting alcohol and drug use and externalizing behavior. We will use IDA to compare the preventive effects of interventions across trial target behaviors (e.g., bullying) and individual factors (e.g., female vs male SGM youth). Findings from this study will fill major gaps in our understanding of how current prevention programs impact suicide risk both generally and in SGM and non-SGM youth, and will provide guidance in directing the next generation of prevention trials targeted towards this at-risk population.

性和性别少数民族(SGM)青年自杀企图的年流行率为29%，上升 比其他年轻人高出4.6倍。我们建议测试预防计划是否针对 直接自杀，或一系列增加自杀风险的因素(内在化症状、酗酒、吸毒 使用、外化、欺凌和人际暴力)总体上降低了年轻人的自杀风险，以及 SGM青年或多或少从这些计划中受益。与广泛的预防试验网络合作 研究人员，我们已经获得了从21个随机预防试验中获得个人水平数据的许可 涉及100,851名参与者。所有试验都包括自杀风险的直接或替代测量，以及信息 关于SGM的地位。尽管所有试验都测试并报告了干预对特定行为的影响 在健康结果方面，很少有人测试对特别报告员青年的具体影响，因为这些青年构成了相对较大的 每项研究的样本比例都很小。我们的工作和其他人的工作表明，结合数据 交叉试验将提供更大的力量来测试几个关于对自杀风险的影响的关键假设，以及 SGM青年是否从这些干预措施中获得不同的好处。我们将使用在我们的 先前的工作，组合这些数据集，并利用来自SGM的两项测量发展研究的结果 和非SGM青少年自杀风险指导高级心理测量分析，以协调结果衡量标准 并开发了一个衡量自杀风险的通用指数。我们将应用综合数据分析(IDA)方法 解释缺失的数据，以检验三组假设。 目的1.测试不同类型的干预措施是否能降低自杀念头和 在一般人群中的年轻人的行为。我们假设预防计划可以降低 不管主要目标是什么，都有自杀倾向。我们将使用IDA在21个试验(n=100,851)上测试这一假设。 目的2.测试对SGM青少年的预防效果是否有所不同。鉴于该公司经常面临的独特风险 ，我们假设预防计划将降低SGM青少年的自杀风险，但将是 与其他年轻人相比，他们的工作效率较低。我们将对5,232名SGM和95,619名非SGM青年进行适度测试。 目的3.检验对SGM青少年的预防效果是否因干预类型的不同而不同。我们 假设针对欺凌和内化症状的干预将更有效地减少 SGM青年的自杀风险与针对酒精和药物使用和外化的干预措施的比较 行为。我们将使用IDA来比较干预措施对试验目标行为的预防效果(例如， 欺凌)和个人因素(例如，女性对男性SGM青年)。 这项研究的发现将填补我们对当前预防方案如何理解的主要空白 对自杀风险的普遍影响，以及对性别歧视和非性别歧视青少年的影响，并将为指导 针对这一高危人群的下一代预防试验。