Experimental evaluation of a multi-site suicide intervention for youth during and after residential placement

寄宿安置期间和之后对青少年进行多地点自杀干预的实验评估

• 批准号: 10625428
• 负责人: Erin Godfrey
• 金额: $ 48.23万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-23 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10625428
• 关键词: 18 year old; Acute; Address; Administrator; Adolescent; Aftercare; American; Area; Behavior; Cancer and Suicide; Caring; Cause of Death; Cessation of life; Characteristics; Child Welfare; Cluster randomized trial; Collaborations; Common Data Element; Communication; Data; Detection; Dialectical behavior therapy; Dimensions; Disease; Educational Status; Effectiveness; Effectiveness of Interventions; Evaluation; Feeling suicidal; Fostering; General Population; Gold; Heterogeneity; Hour; Human Resources; Imprisonment; Impulsivity; Individual; Infrastructure; Intervention; Justice; Knowledge; Legal; Legal system; Letters; Life; Literature; Measures; Medical; Mental Health; Mental Health Associations; Modeling; Moods; New York; New York City; Outcome; Personal Satisfaction; Policies; Population; Prevention; Prevention therapy; Probability; Procedures; Protocols documentation; Public Health; Randomized; Recommendation; Recording of previous events; Registries; Research; Research Personnel; Resources; Risk; Site; Structure; Suicide; Suicide prevention; Surveys; System; Testing; Thinking; Time; Training; Training Programs; Trauma; United States; United States National Institutes of Health; Universities; Vulnerable Populations; Work; Youth; arm; burnout; child services; cluster randomized design; compare effectiveness; coping; demographics; effectiveness testing; evidence base; experience; girls; help-seeking behavior; high risk; ideation; implementation science; improved; juvenile justice system; knowledge base; longitudinal analysis; non-suicidal self injury; preventive intervention; response; skills; skills training; substance use; suicidal; suicidal behavior; suicidal morbidity; suicidal risk; suicide rate; theories; uptake

Abstract/Summary In response to the public health threat that suicide poses to American youth in general and incarcerated youth in particular, we propose a multi-year, multi-site, setting-level intervention in the New York City Juvenile Justice system. In partnership with the NYC Administration for Children's Services (ACS), we will experimentally evaluate an evidence-based staff-level training (S4L) to address youth suicidality during two critical points of contact for juvenile-justice involved youth: placement and post-release Aftercare. S4L combines training in Shield of Care (SOC), an evidence-based model for acute suicide detection training for juvenile justice staff, with evidence-based suicide prevention skill-building training informed by dialectical-behavior therapy for adolescents at risk for suicide ideation, behavior, and non-suicidal self-injury (NSSI). We will compare the effectiveness of S4L to a training as usual control condition (control), and to a condition in which we provide monthly on-site coaching to staff to support the acquisition and implementation of S4L skills (S4L+). The intervention will be implemented as part of ACS's usual staff-training procedures. The need for intervention is urgent at this time due to recent state-level policy shifts that will increase the number youth in these sites and heighten their suicide risk. S4L and S4L+ will be evaluated using a 3-arm cluster-randomized design with the full population of non-secure placement (NSP)/Aftercare sites (N=30 sites; N=1800 youth, 30% girls). These sites are sole infrastructure for long-term confinement in NYC. NSP/Aftercare sites will be randomized to control (N=10 sites; 600 youth), S4L (N=10 sites; 600 youth), and S4L+ (N=10 sites; 600 youth) conditions. We test the effectiveness of S4L compared to S4L+ and control on improving suicidal behavior, suicidal ideation, and NSSI; mental health outcomes (internalizing, externalizing and substance use); and correlates of suicide/mental health (impulsivity, mood, and coping). In addition, we test the extent to which site-level implementation characteristics (e.g., proportion of staff trained; average amount of detection and prevention activities); site and staff-level structural characteristics (e.g., prior training, burnout); and individual youth characteristics (e.g., demographics; trauma history) moderate S4L and S4L+ effectiveness. Youth outcome data on suicidal behavior, suicidal ideation, NSSI, and mental health problems and their correlates will be tracked longitudinally for 1 year. In response to the FOA, outcomes will be assessed via evidence-based measures that capture dimensional facets of disorder in line with NIH's common data elements and recommendations by the National Action Alliance for Suicide Prevention. Site-level intervention moderators will be measured by staff survey and administrative data. This project aims to expand the scientific knowledge base on suicide prevention and intervention in high-stakes youth settings and provide empirically-based guidance regarding the feasibility and scalability of staff training and coaching into different juvenile justice systems and jurisdictions. This project leverages an existing collaboration and has the full support of ACS.

摘要/摘要 为了应对自杀对美国青年和监禁青年的公共卫生威胁 特别是，我们建议在纽约市少年司法中进行多年的多场，设置级别的干预 系统。与纽约儿童服务管理局（ACS）合作，我们将在实验中 评估基于证据的员工级培训（S4L），以解决两个关键点的青年自杀 与青少年的少年合约接触：安置和释放后的后果。 S4L结合了培训 护理盾牌（SOC），一种基于证据的急性自杀检测培训的模型，少年司法人员， 通过辩证的辩证疗法培训的预防自杀技巧培训 有自杀念头，行为和非自杀自我伤害（NSSI）风险的青少年。我们将比较 S4L像往常一样对培训的有效性（控制）以及我们提供的条件 每月在现场教练向员工提供支持和实施S4L技能（S4L+）。这 干预将作为ACS通常的员工培训程序的一部分实施。干预的需求是 由于最近的州级政策转变，此时紧急情况将增加这些地点的年轻人的数量和 提高自杀风险。 S4L和S4L+将使用3臂群集随机设计进行评估 全部非安全放置（NSP）/余后护理站点（n = 30个地点； n = 1800名青年，30％的女孩）。这些 站点是纽约市长期禁闭的唯一基础设施。 NSP/余后护理站点将被随机分为 对照（n = 10个地点； 600名青年），S4L（n = 10个地点； 600名青年）和S4L+（n = 10个地点； 600名青年）。我们 与S4L+相比，测试S4L的有效性以及对改善自杀行为，自杀意念的控制， 和NSSI；心理健康结果（内部化，外在化和药物使用）；并关联 自杀/心理健康（冲动，情绪和应对）。此外，我们测试了哪个站点级别的程度 实施特征（例如，受过培训的员工比例；平均检测和预防量 活动）;站点和员工级的结构特征（例如，事先培训，倦怠）；和个人青年 特征（例如人口统计学；创伤历史）中等S4L和S4L+有效性。青年结果 关于自杀行为，自杀念头，NSSI和心理健康问题及其相关性的数据将是 纵向追踪1年。为了响应FOA，将通过基于证据的结果评估结果 根据NIH的共同数据元素捕获疾病的维度方面的措施 国家预防自杀行动联盟的建议。现场干预主持人将 可以通过员工调查和行政数据来衡量。该项目旨在扩大科学知识 基于预防自杀和干预高风险青年环境，并提供基于经验的 有关员工培训和教练为不同少年司法的可行性和可伸缩性的指导 系统和司法管辖区。该项目利用了现有的合作，并得到了ACS的全部支持。