Preventing Suicide in African American Adolescents

摘要 这项拨款申请的目的是测试适应文化的学校的有效性 基于自杀预防干预，由拉什大学土著社会工作者提供 （即“干预社会工作者”），针对资源匮乏的城市非裔美国人九年级 学生。非裔美国青年的自杀率在 过去 20 年来，自杀是目前非洲人死亡的主要原因之一 美国青少年。因此，需要采取有效、可持续的预防措施 对这些人群的干预措施。我们的研究将培训干预社会工作者提供 适应文化、基于证据的压力预防干预措施（即 青少年应对压力课程 [A-CWS]）。城市非裔美国青少年 参加过 A-CWS 的人表现出自杀风险的降低，以及 焦虑减少，适应性应对的多个维度增加（即使用 积极应对问题经历的策略、积极思考、抑郁应对自我 功效）。我们的目标是证明本土干预社会工作者可以实施 A-CWS 具有保真度，干预小组的参与者由原住民推动 干预社会工作者的适应性应对水平有所提高。我们将检查 人际因素（即归属感受挫、感到负担）的程度 和社会生态因素（即社区暴力暴露、有限的邻里关系） 资源、家庭动态）影响主动自杀意念。我们将测试这些因素是否 影响非裔美国青少年的主动自杀意念。最后，我们的研究将检验 A-CWS 干预降低资源匮乏的城市自杀风险的机制 非裔美国青少年。我们将检查获得的适应性应对技能的能力 通过参与 A-CWS 干预，增加希望并减少绝望。我们 然后将研究希望和绝望对影响的调节作用 人际关系和社会生态因素对主动自杀意念的影响。这项转化研究 具有公共卫生影响。它将扩大对变革机制的理解 与城市非裔美国青少年自杀风险降低有关。它将测试修改后的 针对城市非裔美国青少年的自杀人际理论版本。最后， 我们的研究将为土著精神卫生专业人员的培训和监测提供信息，以 为城市非裔美国青少年提供循证预防干预措施；作为 因此，我们的研究将为预防干预可持续性的实践提供信息， 传播。

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.