Suicide Prevention for Sexual and Gender Minority Youth

性和性别少数青少年的自杀预防

• 批准号: 10495473
• 负责人: Aaron J Blashill
• 金额: $ 74.31万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-09 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10495473
• 关键词: Adolescent; Age; Birth; Cause of Death; Clinical; Communities; Coping Skills; Data; Disparity; Family; Friends; Future; Gender; General Population; Grant; Health Resources; Heterosexuals; Individual; Intervention; Lesbian Gay Bisexual; Literature; Longitudinal Studies; Mental Health; Meta-Analysis; Methods; Motivation; Participant; Persons; Phase; Population; Preparation; Prevalence; Prevention program; Problem Solving; Public Health; Randomized; Randomized, Controlled Trials; Recording of previous events; Reporting; Research; Resources; Safety; Sampling; Services; Sexual and Gender Minorities; Sexual and Gender Minority Youth; Social support; Suicide; Suicide attempt; Suicide prevention; Support Groups; Testing; Vulnerable Populations; Youth; acceptability and feasibility; cisgender; comparison intervention; completed suicide; cost; design; efficacy trial; emerging adult; experience; feasibility testing; gender minority; health disparity; high risk; innovation; intervention participants; intervention program; longitudinal analysis; nonbinary; patient navigation; patient navigator; pilot test; pilot trial; population based; preventive intervention; programs; psychologic; reducing suicide; sex; sexual minority; sexual minority youth; suicidal; suicidal morbidity; therapy design; transgender; trend

PROJECT SUMMARY Suicide is the 10th leading cause of death among all U.S. citizens and is the 2nd leading cause of death among youth and emerging adults between the ages of 15 and 29. One group that is particularly vulnerable to suicide is sexual and gender minorities (SGMs). SGM is an umbrella term used to describe individuals who identify as non-exclusively heterosexual (e.g., gay, lesbian, bisexual) and/or as transgender/non-binary (e.g., identify as a gender different from their birth sex). Indeed, recent U.S. representative findings from 2017 underscore striking disparities in suicidality between sexual minority and heterosexual adolescents, with 23% of sexual minority youth reporting one or more suicide attempts (in the past 12 months) vs. 5.4% of heterosexual youth. Prevalence of lifetime suicide attempts among gender minorities is also substantially elevated compared to the general population, with 45% of 18-24-year-old transgender individuals reporting a history of one more suicide attempts. Despite these substantial health disparities in suicide among SGM youth/emerging adults, no known suicide prevention programs exist for this highly vulnerable population. Given this crucial gap in the literature, the proposed study will adapt and test an innovative intervention that integrates patient navigation with the Safety Planning Intervention (PN+SPI) for SGM youth/emerging adults designed to target mechanisms (e.g., reductions in thwarted belongingness and increases in suicide-related coping skills) that theoretically underlie suicide. If the PN+SPI intervention displays a clinically meaningful effect on the purported targets (i.e., reductions in thwarted belongingness and increases in suicide-related coping skills) during the open-phase trial (R61 phase) and is feasible and acceptable, we will subsequently move to the R33 phase. In the R33 phase, we will conduct a pilot randomized controlled trial of the PN+SPI by comparing it to SPI alone to assess feasibility, acceptability, and preliminary efficacy. During the randomized controlled trial, in which we will sample 170 youth and emerging adult SGMs, we will also evaluate the mechanisms of action of the PN+SPI intervention through longitudinal analysis. The proposed project has substantial public health significance as SGMs are one of the most vulnerable groups for suicidality globally. Given the brevity of the PN+SPI intervention and its emphasis on safety planning and accessing community resources, the PN+SPI intervention has high potential for wide dissemination and public health impact.

项目摘要 自杀是所有美国公民中的第十大死亡原因，是第二大主要原因 年轻人和新兴的成年人在15至29岁之间。一组特别容易自杀 是性和性别少数群体（SGM）。 SGM是用来描述识别为个人的伞 非固有性异性恋（例如，同性恋，女同性恋，双性恋）和/或作为变性者/非二进制（例如，识别为一个 性别与他们的出生性别不同）。确实，2017年的美国最近代表调查结果强调了罢工 性少数和异性恋青少年之间自杀差异，有23％的性少数群体 举报一次或多次自杀企图的青年（在过去的12个月中）和5.4％的异性恋青年。流行率 与一般性相比 人口，有45％的18-24岁跨性别者报告了一次自杀企图的历史。 尽管SGM青年/新兴成年人自杀中存在存在严重的健康差异，但尚无已知的自杀 这个高度脆弱的人群存在预防计划。鉴于文献中的这一关键差距 拟议的研究将适应和测试一种创新的干预措施，将患者导航与安全性整合 SGM青年/新兴成年人的计划干预措施（PN+SPI）旨在针对机制（例如，减少） 从理论上讲是自杀的基础的挫败归属感和自杀相关的应对技巧的提高。如果是 PN+SPI干预对所谓的目标显示出临床上有意义的作用（即减少了挫败 在开放式试验（R61阶段）中，与自杀相关的应对技巧的归属感和增加 可行的和可接受的，我们随后将移至R33阶段。在R33阶段，我们将进行飞行员 PN+SPI的随机对照试验通过将其与SPI进行比较，以评估可行性，可接受性和 初步疗效。在随机对照试验中，我们将在其中采样170名青年和新兴 成人SGM，我们还将评估PN+SPI干预通过纵向的作用机理 分析。拟议的项目具有很大的公共卫生意义，因为SGM是最脆弱的项目之一 全球自杀的组。鉴于PN+SPI干预的简短及其对安全计划的重视 以及获得社区资源，PN+SPI干预具有广泛传播和 公共卫生影响。