Promoting Community Conversations about Research to end Native Youth Suicide in Rural Alaska - Diversity Supplement

促进关于终结阿拉斯加农村地区原住民青少年自杀研究的社区对话 - Diversity Supplement

• 批准号: 10085518
• 负责人: Lisa M. Wexler
• 金额: $ 6.88万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-19 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10085518
• 关键词: Air; Alaska; Alaska Native; American; Attitude; Communities; Community Practice; Educational Intervention; Effectiveness of Interventions; Evidence based intervention; Family; Family member; Friends; Goals; Health; Health Knowledge, Attitudes, Practice; Health Personnel; Home environment; Hospitals; Human Resources; Indigenous; Individual; Intervention; Jail; Knowledge; Learning; Measures; Mental Health; Methods; Mission; Modeling; Occupations; Outcome; Participant; Personal Satisfaction; Persons; Plague; Prevention; Prevention Research; Primary Prevention; Process; Research; Resources; Risk; Risk Factors; Rural; Safety; Schools; Science; Secondary Prevention; Series; Social Network; Social support; Stream; Suicide; Suicide prevention; Testing; Time; Translating; United States National Institutes of Health; Work; Youth; care systems; community based care; community based participatory research; community intervention; experience; health disparity; help-seeking behavior; indigenous community; member; native youth; pedagogy; practice setting; prevent; reducing suicide; rural Alaska; service providers; skills; suicidal; suicidal behavior; suicidal risk; working group

With rates up to 18 times higher for rural Alaska Native (AN) young people when compared to all American youth (124 vs 6.9 per 100,000), the health disparity of youth suicide continues to plague rural Indigenous communities in Alaska. The current system of care—with a focus on mental health—is not effective: 79% of suicide decedents and 62% of attempters received NO mental health care11. Vulnerable AN youth are more likely to come into contact with healthcare providers, school personnel, public safety workers, and other community members11. Additionally, friends and family members noticed signs of risk beforehand in 62% of all recorded suicidal behavior. These villagers can offer culturally-specific social support and safety measures to avert a suicide crisis, but they are not trained to initiate primary and secondary prevention. Currently, three times out of four, community members mobilize only when the person is in `imminent risk' of suicide11. This level of risk means that vulnerable AN youth are taken 500 air miles away for assessment in a confined hospital room many associate with `jail'. After this experience, most AN youth return home less likely to seek help the next time they feel suicidal. Late intervention cuts off options for cultural, family and community-based care, which is preferred by AN youth and their families. To initiate activities to promote wellness, safety and support before a suicide crisis, our tribal working group developed and piloted PC CARES: Promoting Community Conversations About Research to End Suicide. This promising and feasible educational intervention is led by local facilitators, and offers village stakeholders a series of learning circles to study `what we know' from prevention research and figure out how they can apply it to their jobs, families, and lives. The goal of the intervention is to enhance knowledge, skills and attitudes among service providers, family members and tribal residents so that they promote wellbeing, recognize risk, support vulnerable youth, and work with others in their community to take supportive and safety actions when they notice signs of vulnerability. Our community intervention utilizes indigenous pedagogy and prevention science to increase village members' and service providers' capacity to find `up-stream', self-determined and culturally-responsive ways to reduce suicide risk. Using a community-based, participatory research (CBPR) approach, our specific aims track change on both individual and community levels. Aim 1: Track the effect of PC CARES on participants' knowledge, attitudes and behavior, and identify key factors influencing these outcomes over time. Aim 2: Document the community-level impact of PC CARES by tracking the number and type of interactions aimed at preventing youth suicide and promoting wellness in participating villages, and describe changes in the supportive social networks of young people before and after the intervention. IMPACT: Our scalable model offers under-resourced Native communities a practical method for translating scientific research into culturally relevant efforts to reduce suicide risk factors, and increase safety, help-seeking and support to prevent suicide.

与所有美国人相比，阿拉斯加农村原住民（AN）年轻人的发病率高出18倍。 青年（每10万人中有124人对6.9人），青年自杀的健康差距继续困扰着农村土著居民。 阿拉斯加的社区目前的护理系统-重点是精神健康-是无效的：79%的 自杀死者和62%的自杀者没有得到精神健康护理11。易受伤害的青少年更多 可能会接触到医疗保健提供者，学校工作人员，公共安全工作人员和其他 社区成员11.此外，62%的人的朋友和家人事先注意到了危险的迹象。 有自杀行为记录这些村民可以提供具有文化特色的社会支持和安全措施， 避免自杀危机，但他们没有接受过启动初级和二级预防的培训。目前有三 社区成员往往只有在当事人有“迫在眉睫的自杀危险”时才动员起来11。这 风险水平意味着脆弱的AN青少年被带到500空中英里外的一个封闭的 医院病房许多人都会将其与“监狱”联系在一起。有了这段经历，大多数安青年回国后不太可能寻求 帮助他们下次自杀。晚干预切断了文化，家庭和社区为基础的选择 照顾，这是一个年轻人和他们的家庭首选。开展活动，促进健康、安全和 我们的部落工作组开发并试行了PC CARES：促进 关于研究结束自杀的社区对话。这种有前途的可行的教育 干预活动由当地协调员领导，并为村庄利益攸关方提供一系列学习圈，以研究“什么是 我们从预防研究中了解到，并弄清楚他们如何将其应用到他们的工作，家庭和生活中。的 干预措施的目标是提高服务提供者、家庭成员、 和部落居民，使他们促进福祉，认识到风险，支持弱势青年，并与 当他们注意到脆弱的迹象时，他们社区中的其他人采取支持和安全行动。我们 社区干预利用土著教育学和预防科学， 服务提供者有能力找到“上游”、自主和顺应文化的方式， 自杀风险使用基于社区的参与式研究（CBPR）方法，我们的具体目标跟踪 在个人和社区层面上的变化。目标1：跟踪PC CARES对参与者 知识、态度和行为，并确定随着时间的推移影响这些结果的关键因素。目标二： 通过跟踪旨在实现以下目标的互动的数量和类型，记录PC CARES的社区影响 预防青少年自杀和促进参与村庄的健康，并描述 在干预之前和之后，年轻人的支持性社交网络。影响：我们的可扩展模型 为资源不足的原住民社区提供了一种将科学研究转化为文化的实用方法。 相关的努力，以减少自杀风险因素，并增加安全，寻求帮助和支持，以防止自杀。