A Prospective Study of Suicide Prevention in the USAF

描述（由申请人提供）：这个提案的总体目标是让我发展必要的技能，成为一名独立的研究者和主要学者，设计和评估社区预防性心理健康干预研究的有效性。我的主要重点是预防自杀。我有一个独特的机会来回顾和展望美国空军开发的一个项目的影响，这个项目可能已经实施了有效的策略来降低其成员的自杀率。美国空军的项目是社区层面预防的一个不寻常的例子，专门解决自杀预防问题，以及一般的精神健康疾病，整合了普遍和有针对性的预防方法。在美国，预防自杀和相关疾病的研究和项目一直萎靡不振，而其他公共卫生挑战却没有。这在一定程度上是由于缺乏解决心理健康问题，特别是自杀问题的政治和社会意愿。最近，我们国家的最高公共卫生官员，美国卫生局局长承认预防自杀和自杀行为是国家的优先事项。综上所述，我目前有能力进入一个“自然主义实验室”，在政治上迫切需要提高自杀预防领域的地位，这为参与推进精神预防心理健康领域提供了巨大的潜力。随着心理健康预防试验领域的发展，调查人员的可用性将变得至关重要，他们不仅接受过广泛的培训，不仅可以进行项目评估，还可以指导和开展实地试验，以评估干预措施的有效性。我建议通过一个由导师、专家顾问和合作者组成的跨学科团队，参与一个严格的培训项目，来过渡到这种能力水平。这个职业发展奖将建立在我在流行病学和公共卫生、社会科学和基础科学研究方面已经很强的技能之上。它的目的是提高我在预防心理健康方面的知识和技能，重点是自杀，并开发适用于实地试验的调查方法的新技能。本提案的主要研究问题是调查美国空军自杀预防计划是否导致自杀事件、自杀未遂和相关发病率（如家庭暴力、酗酒和抑郁症）的减少，并随着时间的推移保持减少。

DESCRIPTION (provided by applicant): The overall goal of this proposal is to allow me to develop the skills necessary to become an independent investigator and a leading scholar in the design and evaluation of the effectiveness of community-based preventive mental health intervention research. My primary focus will be on prevention of suicide. I have a unique opportunity to assess, both retrospectively and prospectively, the effects of a program developed in the United States Air Force that may have implemented effective strategies for reducing the suicide rate among its members. The program in the USAF is an unusual example of a community level prevention to address suicide prevention specifically, and mental health illness in general, integrating universal and targeted approaches to prevention. In the United States, research and programs on prevention of suicide and related morbidities has languished while other public health challenges have not. In part this has been due to the lack of political and social will to address mental health problems, especially suicide. Recently, our nation's top leading public health official, the U.S. Surgeon General recognized prevention of suicide and suicidal behaviors as a national priority. Taken together, my current capacity to access a "naturalistic laboratory", in a climate of political imperative to advance the status of the field of suicide prevention, renders a prospect of tremendous potential for participating in advancing the field of mental preventive mental health. As the field of preventive trials for mental health moves forward, the availability of investigators who are broadly trained not only to conduct program evaluations but also can direct and carry out field trials for the evaluation of the effectiveness of interventions will become vital. I propose to transition to this level of competency, through engaging in a rigorous training program with a interdisciplinary team of mentors, expert consultants and collaborators. This career development award will build upon my already strong skills in epidemiology and public health, social sciences, and basic science research. It is designed to enhance my knowledge and skills in preventive mental health, focusing on suicide, and to develop new skills in investigative methodologies applicable to field trials. The major research question of this proposal is to investigate whether the USAF Suicide Prevention Program results in a reduction in events of suicide, attempted suicide, and related morbidities, such as domestic violence, alcoholism and depression and maintains the reduction over time.