2/2 - Suicide Prevention in Chinese Older Adults

描述（由申请人提供）：这两个站点（拉什大学和西北大学）链接的R34MH100443合作申请的重新提交旨在设计一种适合文化和社区参与的干预措施，以减少美国华裔老年人的自杀念头，他们的自杀率高于任何其他种族/族裔群体。尽管存在这种健康差异，但我们对中国人口自杀的文化问题了解甚少，这直接阻碍了干预工作。因此，我们寻求支持一位在老龄化、心理健康和中国文化方面具有专业知识的老年病专家（董）和一位在使用社区卫生工作者减少少数民族人群健康差异的临床试验方面具有专业知识的干预专家（西蒙）。更具体地说，我们的目标是1)扩大协同的学术和社区伙伴关系；2)迭代设计和完善具有文化意义的试点干预措施，以减少自杀念头；3)进行试点随机对照试验；4)在多个层面上严格评估拟议干预的文化可接受性。本研究将为下一个R01应用奠定基础，以充分测试文化定制干预对减少中国老龄化人口自杀念头的有效性。到2030年，中国老年人口将占世界老年人口的四分之一。尽管在美国的华人人口增长迅速，但中国老年人之间存在着明显的健康差异，而研究中国人口时复杂的语言和文化差异，尤其是在自杀念头问题上，进一步加剧了这种差异。此外，一直没有足够和可持续的社区支持，使华人社区能够作为平等的伙伴充分参与研究。在这项申请中，一位双语和双文化的首席研究员和一个跨学科的调查团队利用了基于社区的参与性研究（CBPR）的原则，建立在我们之前NIH资助的CBPR项目的基础上，与芝加哥华人社区进行协同和可持续的合作，以克服这些挑战，并为本提案奠定基础。研究结果将为临床医生、调查人员、社区、社会服务和政策制定者提供信息：a)提高我们对自杀相关文化问题的深入理解；B)使社区成为精神卫生研究的平等伙伴；c)指导下一步R01干预研究；d)为中国老年人自杀护理的实践和政策提供信息。

DESCRIPTION (provided by applicant): This two-site (Rush University and Northwestern University) linked re-submission of R34MH100443 collaborative application aims to design a culturally tailored and community- engaged intervention to reduce suicidal thoughts in US Chinese older adults, who have the highest suicide rate than any other racial/ethnic groups. Despite this health disparity, we have great paucity in our understanding of cultural issues surrounding suicide in Chinese populations, and this has directly hampered the intervention efforts. Accordingly, we seek to support a geriatrician (Dong) with expertise in aging, mental health and Chinese culture, and an interventionist (Simon) with expertise in clinical trials using community health workers to reduce health disparities among minority populations. More specifically, we aim to 1) expand synergistic academic and community partnerships; 2) iteratively design and refine a culturally meaningful pilot intervention to reduce suicidal thought; 3) conduct a pilot randomized controlled trial; and 4) rigorously evaluate the cultural acceptability of the proposed intervention at multiple levels. This study will set the cornerstone for the next R01 application to fully test the efficacy of a culturally tailored intervention to reuce suicidal thoughts in Chinese aging populations. By 2030, Chinese older adults will account for a quarter of the world's aging populations. Despite the rapid growth of Chinese populations in the US, there are marked health disparities among Chinese older adults, which are further exacerbated by the complex linguistic and cultural nuances in studying Chinese populations, particularly on issues of suicidal thoughts. Moreover, there has been inadequate and sustainable community support necessary to empower the Chinese community to be fully engaged as equal partners in research. In this application, a bilingual and bicultural principal investigator and an interdisciplinary investigative team have leveraged the principles of community-based participatory research (CBPR), building on our prior NIH funded CBPR projects to partner synergistically and sustainably with the Chicago Chinese community in order to overcome these challenges and set the foundation for this proposal. The study findings will inform clinicians, investigators, communities, social services and policy makers to: a) improve our in-depth understanding of cultural issues surrounding suicide; b) empower community to be equal partners in mental health research; c) guide the next R01 intervention study; and d) inform practice and policy on suicide care in Chinese older adults.