Suicide Prevention Study

社会决定因素的作用在阿拉斯加原住民（AN）青年的高比例中很明显。 在整个农村地区，自杀率可能比美国青年总人数高出18倍。 15 - 19岁人口（每10万人中124人对6.9人）。尽管它们很重要，但人们对它们知之甚少。 农村AN社区为保护其青年而制定的社区一级的复原力和保护程序。 我们的研究旨在确定这些更大的社会和社区进程的途径，因为它们 个人，青年对自杀的适应力，以便为AN青年的各种预防工作提供信息。 拟议的研究将使用协作混合方法的方法来：（a）确定可变的社区水平 保护因素似乎影响青年自杀;（B）测试社区保护因素的作用， （c）制订和传播一套实用的 评估和加强社区一级保护、减少自杀风险和提高青年 resilience.阿拉斯加原住民复原力研究（ANRRS）有以下具体目标：1）评估 一系列可改变的文化、社区和体制因素（保护性社区）的结合 自杀、自杀行为（意念、企图）和相关不良结局（意外 死亡，酒精滥用需要医疗保健）在64个农村和偏远的阿拉斯加原住民村庄，以确定 最能预测青年健康结果的社区因素; 2）在分层随机抽样中， 六个社区使用定量方法来测试个人层面青少年保护的多层次模型， 因素，由一组社区层面的因素调节，作为个人层面的青年韧性的预测因素， 自杀风险结果; 3）开发和传播一种方法-阿拉斯加社区复原力地图 （AK-CRM）-让社区衡量和战略性地加强这些社区层面的因素， 提高他们的保护能力，以增进青年健康，减少自杀风险。开展 我们的团队将与我们的长期社区研究伙伴合作， 阿拉斯加自杀率最高的三个地区：北极西北部、诺顿湾和育空地区库斯科奎姆。 随着研究的进展，我们将与阿拉斯加土著合作中心分享初步结果， 韧性研究（ANCHRR），以确保其相关性在整个阿拉斯加，并将传播结果 AK-CRM工具遍布全国。部落知识的整合和参与这项研究将 满足当地需求，同时最大限度地提高研究的公共卫生影响。这项工作的目标是确定至关重要的 社区层面的目标，可以最有效地帮助减少青少年自杀风险，并促进 resilience.我们的方法将为社区成员提供一种文化响应方法， 以反映社区优先事项、认识论、本体论和实践的方式增强其优势， 为预防自杀提供可持续的解决方案

The role of social determinants is evident in the disproportionately high rates of Alaska Native (AN) youth suicide that when aggregated across a rural area, can be 18 times higher than the U.S. youth general population for ages 15-19 (124 vs 6.9/ per 100,000). Despite their importance, little is yet known about the community-level resilience and protective processes that rural AN communities enact to protect their youth. Our research seeks to identify the pathways from these larger social and community processes as they individual, youth resilience from suicide, in order to inform a wide variety of prevention efforts with AN youth. The proposed study will use a collaborative mixed methods approach to: (a) identify mutable community-level protective factors that appear to impact youth suicide; (b) test the role of community protective factors and mechanisms, in a multi-level model of youth suicide resilience; and (c) develop and disseminate a practical tool to assess and strengthen community-level protection and reduce suicide risk and increase youth resilience. The Alaska Native Resilience Research Study (ANRRS) has the following specific aims: 1) Assess the association of a set of modifiable cultural, community and institutional factors (protective community factors) with suicide, suicidal behaviors (ideation, attempt), and associated adverse outcomes (accidental death, alcohol-misuse requiring healthcare) in 64 rural and remote Alaska Native villages to identify community-level factors that are most predictive of youth health outcomes; 2) In a stratified random sample of six communities use quantitative methods to test a multi-level model of individual-level youth protective factors, moderated by a set of community-level factors, as predictors of individual-level youth resilience from suicide risk outcomes; and 3) develop and disseminate a method—Alaska Community Resilience Mapping (AK-CRM)—for communities to measure and strategically strengthen these community-level factors to enhance their protective capabilities to increase youth health and reduce the risk for suicide. To conduct the proposed suicide prevention study our team will work with our long-term community research partners in the three Alaska regions with the highest suicide rates: Northwest Arctic, Norton Sound, and Yukon Kuskokwim. As the research progresses, we will share preliminary results with the Alaska Native Collaborative Hub for Resilience Research (ANCHRR) to ensure its relevance throughout Alaska and will disseminate the resulting AK-CRM tool throughout the state. The integration of tribal knowledge and participation in this research will address local needs while maximizing the study’s public health impact. The goal of this work is to identify vital community-level targets that can most effectively contribute to the reduction of youth suicide risk and promote resilience. Our approach will offer a culturally-responsive method for community members to document and bolster their strengths in ways that reflect community priorities, epistemologies, ontologies, and practices, contributing to sustainable solutions for suicide prevention