Early Intervention for Suicide Risk among Immigrant Youth

移民青年自杀风险的早期干预

• 批准号: 10654892
• 负责人: Kiara Alvarez
• 金额: $ 10.38万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10654892
• 关键词: Early; Intervention; Suicide; Risk; among

PROJECT SUMMARY Background. Suicide is the second leading cause of death among 15-24 year olds in the United States, yet there is a dearth of evidence-based prevention programs that explicitly address suicide risk factors prior to the onset of suicide attempts. First and second generation immigrant youth comprise 25% of the U.S. population under 18 and experience specific risk factors for suicidal ideation and attempts. This includes family conflict exacerbated by differing cultural expectations between parents and children and disruptions to parent-child communication. At the same time, family-based preventive interventions focused on enhancing family protective factors show promise for reducing later suicide risk. Research Strategy. The present study focuses on developing and testing a family-based preventive intervention for suicide risk through three interrelated projects. These are: 1) Conducting longitudinal analyses of two existing datasets to identify how social support assets (e.g., experiences of family, peer, and community support) buffer suicide risk for adolescents at high risk of suicidal behavior, and examining how these associations may vary by gender and racial/ethnic group; 2) Utilizing intervention mapping and qualitative data to develop and refine a new preventive intervention, the Early Intervention for Suicide Risk among Immigrant Youth; and 3) Pilot testing the early intervention with first and second generation immigrant Latino/a adolescents screening positive for suicide risk and their families. 40 families will be randomized to the intervention or to usual care. Feasibility, acceptability, and impact on the intervention targets will be assessed. Training Plan. In coordination with the research plan, Dr. Alvarez will pursue training in the following three areas: 1) methodological approaches relevant to development and evaluation of preventive interventions targeting low base rate behaviors; 2) innovative approaches to assessment of suicide risk in clinical research contexts; and 3) design and testing of prevention programs delivered in healthcare, school, and community settings, with a particular focus on suicide prevention. Her research will be based at the Disparities Research Unit in Massachusetts General Hospital, a Harvard Medical School affiliated, major medical center providing access to an abundance of clinical research resources and training opportunities. Mentorship. The project’s mentorship team provides a range of complementary expertise relevant to the research and training aims of this proposal. Dr. Alvarez’s primary mentor, Dr. Alegria, is an expert in health disparities and health services research with extensive experience in mentoring early career investigators, including K awardees. Her co-mentor Dr. Wyman provides expertise in youth suicide prevention and prevention research, and co-mentor Dr. Shrout provides expertise in statistical modeling of longitudinal data and analysis of clinical trial outcomes. A team of advisors provides additional expertise in the epidemiology of depression and suicidal behaviors (Dr. Roberts), adaptive testing for mental health assessment (Dr. Gibbons), family-based preventive intervention design and evaluation (Dr. Pantin), and clinical trials for depression and related disorders (Dr. Alpert). Candidate. Dr. Alvarez is an early career researcher trained in school and child clinical psychology who is completing NIMH-funded postdoctoral training in health disparities and mental health services research focused on culturally diverse populations. This K23 project would provide the foundation to launch her career as a clinical researcher specializing in suicide prevention, with a particular focus on interventions addressing the needs of immigrant youth and on family-based preventive interventions delivered in healthcare and community settings.

项目概要 背景。自杀是美国 15-24 岁人群的第二大死因，但 缺乏基于证据的预防计划，可以在自杀之前明确解决自杀风险因素 自杀企图的发生。第一代和第二代移民青年占美国人口的 25% 18 岁以下，经历自杀意念和自杀企图的特定风险因素。这包括家庭冲突 父母和孩子之间不同的文化期望以及亲子间的干扰加剧了这种情况 沟通。与此同时，以家庭为基础的预防干预措施侧重于加强家庭 保护性因素有望降低以后的自杀风险。研究策略。目前的研究重点 通过三个相互关联的项目开发和测试基于家庭的自杀风险预防干预措施 项目。这些是：1）对两个现有数据集进行纵向分析，以确定社会支持如何 资产（例如家庭、同伴和社区支持的经历）可以缓冲高青少年的自杀风险 自杀行为的风险，并研究这些关联如何因性别和种族/族裔群体而异； 2） 利用干预措施图和定性数据来开发和完善新的预防干预措施 移民青年自杀风险的早期干预； 3）首先对早期干预进行试点测试 以及自杀风险筛查呈阳性的第二代拉丁裔移民/青少年及其家人。 40 家庭将被随机分配接受干预或常规护理。可行性、可接受性以及对项目的影响 将评估干预目标。培训计划。与研究计划相协调，阿尔瓦雷斯博士将 开展以下三个领域的培训：1) 与发展和发展相关的方法方法 评估针对低基础率行为的预防性干预措施； 2）创新方法 临床研究背景下自杀风险的评估； 3）预防方案的设计和测试 在医疗保健、学校和社区环境中提供，特别关注自杀预防。她 研究将在哈佛医学院马萨诸塞州总医院的差异研究中心进行 学校附属的主要医疗中心提供丰富的临床研究资源和 培训机会。指导。该项目的导师团队提供了一系列补充 与本提案的研究和培训目标相关的专业知识。阿尔瓦雷斯博士的主要导师阿莱格里亚博士， 是健康差异和卫生服务研究方面的专家，在早期指导方面拥有丰富的经验 职业调查员，包括 K 获奖者。她的共同导师怀曼博士提供青少年自杀方面的专业知识 预防和预防研究，共同导师 Shrout 博士提供统计建模方面的专业知识 临床试验结果的纵向数据和分析。顾问团队提供额外的专业知识 抑郁症和自杀行为的流行病学（罗伯茨博士），心理健康适应性测试 评估（Gibbons 博士）、基于家庭的预防干预设计和评估（Pantin 博士）以及临床 抑郁症和相关疾病的试验（阿尔珀特博士）。候选人。阿尔瓦雷斯博士是一位早期职业研究员 接受过学校和儿童临床心理学培训，正在完成 NIMH 资助的健康博士后培训 差异和心理健康服务研究侧重于文化多元化人群。这个K23项目 将为她作为一名专门从事自杀预防的临床研究员开展职业生涯奠定基础， 特别注重解决移民青年需求的干预措施和基于家庭的 在医疗保健和社区环境中提供的预防性干预措施。

项目成果

Role of social determinants in anxiety and depression symptoms during COVID-19: A longitudinal study of adults in North Carolina and Massachusetts.

• DOI: 10.1016/j.brat.2022.104102
• 发表时间: 2022-07
• 期刊: BEHAVIOUR RESEARCH AND THERAPY
• 影响因子: 4.1
• 作者: Alegria, Margarita;Cruz-Gonzalez, Mario;O'Malley, Isabel Shaheen;Alvarez, Kiara;Stein, Gabriela Livas;Fuentes, Larimar;Eddington, Kari;Poindexter, Claire;Markle, Sheri Lapatin;Thorndike, Anne N.;Zhang, Lulu;Shrout, Patrick E.
• 通讯作者: Shrout, Patrick E.