Lumbee Rite of Passage: A Suicide Prevention Model for American Indian Youth

Lumbee 成年仪式：美国印第安青年的自杀预防模式

• 批准号: 7990933
• 负责人: Ronny A Bell
• 金额: $ 22.2万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-05 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7990933
• 关键词: Acculturation; Adolescent; Affect; African American; Age; American; American Indians; Communities; Country; County; Dancing; Data; Ethnic group; Feasibility Studies; Feedback; Feeling hopeless; Feeling suicidal; Focus Groups; Gatekeeping; Gender; Goals; Health; Health Resources; Hearing; Home environment; Individual; Intervention; Interview; Knowledge; Latino; Lead; Life; Lumbee tribe; Measures; Mental Health; Mental disorders; Mississippi; Modeling; North Carolina; Obesity; Outcome; Participant; Perception; Population; Poverty; Preventive Intervention; Public Health; Randomized; Recording of previous events; Research; Research Personnel; Reservations; Risk Factors; Rivers; Running; Rural; Services; Sex Orientation; Social support; Study models; Substance abuse problem; Suicide; Suicide attempt; Suicide prevention; Surveys; Testing; Tribes; United States; Universities; Ursidae Family; Youth; accomplished suicide; base; boys; comparison group; depressive symptoms; experience; forest; girls; health equity; impression; improved; innovation; medical schools; member; post intervention; programs; public health relevance; self esteem; suicidal behavior; suicide rate

DESCRIPTION (provided by applicant): Suicide is a threat to the health of all Americans, but some ethnic groups are more affected than others. Limited data indicate that American Indian (AI) youth experience high rates of suicide completions, suicide attempts, and suicidal ideation compared to their non-Latino white counterparts. Many factors contribute to suicidal ideation in AI youth, including depressive symptoms, low self-esteem, substance abuse, hopelessness, forced acculturation, and lack of social support. Cultural interventions (interventions that utilize cultural practices to intervene on health outcomes, as distinguished from interventions that are merely culturally appropriate) have recently been associated with positive health outcomes in AIs as well as other ethnic groups. Still, while it is highly recommended that interventions targeting mental illness in AI youth consider cultural constructs related to health, very few studies have used this approach to-date. North Carolina (NC) is home to the largest AI population east of the Mississippi River. The Lumbee Indian tribe, a non- reservation tribe with a population of about 50,000, is the largest tribe in the state and is largely concentrated in Robeson County. The overall goal of the proposed exploratory study, Lumbee Rite of Passage for Life, is to determine the impact of cultural programs, specifically a culture class conducted by the Lumbee tribe at three tribally owned Boys and Girls Clubs, on suicide ideation in American Indian adolescents between the ages of 12 and 17 years. The study will entail participation from the Lumbee community and will be conducted as a partnership between the Maya Angelou Center for Health Equity (MACHE) at Wake Forest University School of Medicine (WFUSM), the University of NC at Pembroke (UNCP), and the Lumbee Tribe of NC. This exploratory R21 will accomplish two specific aims: (1) to assess perceptions regarding suicidal behavior and risk factors for suicide and examine mental health needs among and services for Lumbee Indian youth (ages 12-17 years) in Robeson County, NC; and (2) to determine the impact of a tribally-run cultural program on suicidal ideation and its risk factors. A secondary aim to Specific Aim 2 is to examine the moderating effects of demographic variables (including gender), sexual orientation, and obesity on the relationship between participation in the culture classes and suicidal ideation. For Aim 1, we plan in-depth interviews with community gatekeepers regarding availability and quality of mental health resources and focus groups with Lumbee youth to identify impressions of mental health issues, particularly regarding suicide and its risk factors in their community. For Aim 2, investigators will conduct a feasibility study in conjunction with the Lumbee tribe to measure changes in suicidal ideation and its risk factors that occur as a result of participation in a cultural program that includes native dancing, pow-wow singing, NC Indian history, beading, and pottery. Participants will be randomized into intervention and delayed intervention (comparison) groups, and pre- and post-intervention measures of suicide ideation and factors associated with it will be collected via surveys. PUBLIC HEALTH RELEVANCE: Suicide and its risk factors remain a major public health concern in the United States, and American Indians bear an unequal burden of completed suicides, suicide attempts, and suicidal ideation compared to whites. The proposed exploratory study is a partnership with the Lumbee Indian tribe of North Carolina and will test the feasibility of using a tribally run culture class to promote positive mental health outcomes and reduce suicidal behaviors among Lumbee adolescents. While we acknowledge that culture may only be one of many things that promote good mental health among young people, innovative research such as this could lead to more comprehensive treatment and prevention interventions and therefore add to the body of public health knowledge.

自杀是对所有美国人健康的威胁，但某些族裔群体比其他人受到的影响更大。有限的数据表明，美国印第安人（AI）青年的自杀完成率，自杀未遂率和自杀意念率高于非拉丁美洲白色青年。许多因素导致AI青少年的自杀意念，包括抑郁症状，低自尊，药物滥用，绝望，强迫文化适应和缺乏社会支持。文化干预（利用文化习俗干预健康结果的干预措施，区别于仅在文化上适当的干预措施）最近与人工智能以及其他种族群体的积极健康结果有关。尽管如此，尽管强烈建议针对人工智能青少年精神疾病的干预措施考虑与健康相关的文化结构，但迄今为止很少有研究使用这种方法。北卡罗来纳州（NC）是密西西比河以东AI人口最多的地方。伦比印第安部落是一个非保留地部落，人口约5万，是该州最大的部落，主要集中在罗伯逊县。拟议的探索性研究的总体目标，Lumbee仪式的生命通道，是确定文化节目的影响，特别是文化类进行的Lumbee部落在三个部落拥有的男孩和女孩俱乐部，在美国印第安青少年的自杀意念的12和17岁之间。这项研究将需要Lumbee社区的参与，并将作为维克森林大学医学院（WFUSM）的Maya Angelou健康公平中心（CQE），彭布罗克的NC大学（UNCP）和NC的Lumbee部落之间的合作伙伴关系进行。这一探索性的R21将实现两个具体目标：（1）评估对自杀行为和自杀风险因素的看法，并检查北卡罗来纳州罗伯逊县Lumbee印第安青年（12-17岁）的心理健康需求和服务;（2）确定部落文化计划对自杀意念及其风险因素的影响。具体目标2的第二个目的是研究人口统计学变量（包括性别）、性取向和肥胖对文化课参与和自杀意念之间关系的调节作用。对于目标1，我们计划与社区守门人进行深入访谈，了解心理健康资源的可用性和质量，并与Lumbee青年进行焦点小组访谈，以确定对心理健康问题的印象，特别是关于自杀及其在社区中的风险因素。对于目标2，研究人员将与Lumbee部落一起进行可行性研究，以测量自杀意念及其风险因素的变化，这些变化是由于参与文化项目而发生的，该项目包括土著舞蹈，pow-wow唱歌，NC印第安历史，串珠和陶器。参与者将被随机分为干预组和延迟干预（比较）组，并通过调查收集干预前后的自杀意念及其相关因素的测量结果。 公共卫生关系：自杀及其危险因素仍然是美国的一个主要公共卫生问题，与白人相比，美国印第安人在自杀未遂、自杀未遂和自杀意念方面承担着不平等的负担。拟议的探索性研究是与北卡罗来纳州的Lumbee印第安部落的合作伙伴关系，将测试使用部落运行的文化课程来促进积极的心理健康结果和减少Lumbee青少年自杀行为的可行性。虽然我们承认文化可能只是促进年轻人良好心理健康的众多因素之一，但像这样的创新研究可能会导致更全面的治疗和预防干预措施，从而增加公共卫生知识。