Preventing Suicide in African American Adolescents

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Abstract The aim of this grant application is to test the effectiveness of a culturally-adapted, school- based suicide prevention intervention, delivered by indigenous Rush University social workers (i.e., “intervention social workers”), for low-resourced, urban, African American 9th grade students. Rates of suicide among African American youth have increased substantially in the past 20 years, and suicide is currently one of the leading causes of death among African American adolescents. As such, there is a need for effective, sustainable prevention interventions for these populations. Our study will train intervention social workers to deliver a culturally-adapted, evidence-based coping with stress prevention intervention (i.e., the Adolescent Coping with Stress Course [A-CWS]). Urban African American adolescents who have participated in the A-CWS have demonstrated decreases in suicide risk, as well as decreases in anxiety and increases in several dimensions of adaptive coping (i.e., use of positive coping strategies for problem experiences, positive thinking, depression coping self- efficacy). We aim to demonstrate that indigenous intervention social workers can implement the A-CWS with fidelity and that participants in intervention groups facilitated by indigenous intervention social workers experience increases in levels of adaptive coping. We will examine the extent that interpersonal factors (i.e., thwarted belongingness, perceived burdensomeness) and socio-ecological factors (i.e., community violence exposure, limited neighborhood resources, family dynamics) influence active suicidal ideation. We will test whether these factors influence active suicidal ideation in African American adolescents. Lastly, our study will examine the mechanism by which the A-CWS intervention reduces suicide risk for low-resourced, urban African American adolescents. We will examine the ability of adaptive coping skills, gained through participation in the A-CWS intervention, increase hope and reduce hopelessness. We will then examine the moderating effects of hope and hopelessness on the influence of interpersonal and socio-ecological factors on active suicidal ideation. This translational study has public health implications. It will expand the understanding of mechanisms of change related to suicide risk reduction in urban African American adolescents. It will test a modified version of the Interpersonal Theory of Suicide for urban African American adolescents. Lastly, our study will inform the training and monitoring of indigenous mental health professionals to deliver evidence-based prevention interventions for urban African American adolescents; as such, our study will inform the practice of prevention intervention sustainability and dissemination.