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SAFETY-A for Promoting Equity in Suicide Prevention Outcomes in Schools

SAFETY-A 促进学校自杀预防成果的公平

基本信息

批准号：
10247365
负责人：
ANNA Shan-Lai LAU
金额：
$ 25.02万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10247365
关键词：
Accident and Emergency department Acute Address Administrator Adolescent Age American Asian Americans Caregivers Caring Case Series Characteristics Clinical Cluster randomized trial Coercion Cognitive Therapy Collaborations Communication Continuity of Patient Care Data Death Rate Detection Distress Emergency department visit Emotions Ethnic group Family Feedback Feeling suicidal Funding Hospitalization Human Hybrids Intervention Investigation Latina Latinx Low income Mental Health Mental Health Services Methods Minority Groups Not Hispanic or Latino Outcome Parents Perception Phase Policies Protocols documentation Provider Randomized Reporting Research Resources Risk Risk Assessment Schools Structure Students Suicide Suicide attempt Suicide prevention Symptoms Teenagers Testing Time Training Support Trust United States National Institutes of Health Youth acceptability and feasibility base design disparity reduction effectiveness implementation trial emotional distress ethnic minority population evidence base follow-up health service use hybrid type 1 trial implementation outcomes implementation science implementation strategy improved medical specialties minority student peer pilot trial primary outcome prototype provider adherence racial and ethnic racial and ethnic disparities racial disparity randomized trial response school district secondary outcome service providers skills training social stigma suicidal suicidal adolescent suicidal behavior suicidal risk therapy development workforce needs

项目摘要

PROJECT SUMMARY Ethnic minority adolescents, including Asian American and Latinx adolescents are at increased risk for suicidal thoughts and attempts compared to their Non-Hispanic White (NHW) peers, yet they are less likely to receive mental health services (MHS) after their suicide risk is identified. Although school-based MHS reduce access barriers, racial disparities persist within suicide prevention efforts in schools. The proposed study will adapt Safe Alternatives For Teens and Youth – Acute (SAFETY-A) for implementation in low-resourced school districts to target putative mechanisms underlying disparities in MHS use following youth suicide risk detection. SAFETY-A will be adapted to reduce mistrust of MHS, internalized stigma, and concealment of youth emotional distress that drive poor engagement in MHS among Asian American and Latinx students and families. Furthermore, SAFETY-A delivery parameters and implementation strategies will be adapted to fit the organizational context of school district policies and protocols, resource constraints, and workforce needs. The proposed intervention development study will include three phases. First, stakeholders will be engaged to design adaptations to the intervention and implementation strategy. Provider, youth and caregiver input will be gathered using human-centered design approaches to adapting the SAFETY-A intervention content to address disparities mechanisms. School district leaders, school administrators, and MHS providers will help to develop a tailored implementation strategy to fit local training and support needs across a range of district contexts. Second, a prototyping case series will inform iterative refinements of SAFETY-A in one school district. Third, a pilot controlled trial will randomize school districts to the timing of implementation to provide preliminary data on the impact of SAFETY-A on proposed mechanisms of action (trust in MHS, stigma, youth emotion communication) and the primary outcome of MHS utilization and the secondary outcome of suicidal thoughts and behaviors across racial/ethnic groups. Mixed methods will be used to assess implementation outcomes of provider adherence, and perceptions of feasibility, acceptability and fit. The proposed project will provide preliminary data on feasibility and potential impacts on putative mechanisms to propose a definitive Hybrid Type 1 trial to test SAFETY-A as an intervention to reduce racial/ethnic disparities in MHS utilization among suicidal youth.

项目总结