Individual and Community and Organizational Factors for Suicide Risk in the USAF

描述（由申请人提供）：2006年，我们通过1 R 01 MH 075017获得资助，研究美国空军（AF）自杀事件的实施和减少之间的关系。为了做到这一点，我们建议使用从AF开始服务到自杀事件或非自杀事件的时间的个体水平观察结果，将AF人员文件中每个相关协变量的个体水平数据联系起来。我们从项目一开始就致力于在进行任何分析之前对所有数据进行去识别，以保护所有AF人员的隐私和机密性。我们包括了一些独立的预测因素，协变量和随时间变化的因变量。事实证明，构建这个复杂的数据库是一个比我们预期的更大的挑战。我们的时间相关变量包括部署和重新部署等过渡以及个人生活的变化（例如年龄，职业，婚姻状况，级别变化或位置变化）。进入这个项目，我们知道最终数据库的质量将取决于我们的能力：（1）获得对众多AF和国防部数据源的访问权;（2）开发一个安全的流程，用于对所有个人级别的数据进行去识别;（3）每季度更新个人级别的关键转换和更改。我们花了四年的大部分时间才确信我们已经建立了一个纵向的、相互联系的数据库，这个数据库是安全的，可以保护所有Ar部队人员的机密性和隐私。我们还有一个久经考验、经验丰富、整合良好的团队，他们共同完成了这项工作，并计划在获得资金的情况下共同开展下一阶段的工作。我们现在已经做好了充分的准备，在自杀研究中开发新的方法，利用这个强大的和信息丰富的纵向数据，从2003年开始的队列，可以不断更新。我们已经完成了我们以前的目标，涉及检查整个服务中空军自杀预防计划的实施水平之间的关系，并确定了该计划的哪些组成部分似乎具有最强的效果（Knox KL，Pflanz S，Talcott GW，Campise RL，Lavigne JE，Bajorska A，Tu X，Caine ED.空军自杀预防计划：对公共卫生政策的影响。American Journal of Public Health; [Epub ahead of print：May 13，2010，10.2105]）。我们已经增加了来自多个来源的数据，并有机会在未来利用新的数据源，以加强数据库。我们现在是理想的准备检查的影响和个人，社区和组织因素的相互作用对自杀的风险在AF。我们建议这样做，通过开发预测模型，使用新的举措在AF的实施，以减少自杀。这些新举措的关键是提高AF人员的复原力和早期识别高风险AF人员，仍然通过预防自杀的公共卫生模式框架提供。

DESCRIPTION (provided by applicant): In 2006 we were funded through 1 R01 MH075017 to study the relationship between implementation and reductions in events of suicide in the United States Air Force (AF). In order to do that, we proposed to link individual level data from the AF personnel files for each of the covariates of interest using individual level observations on time from the beginning of service in the AF to an event or non-event of suicide. We were committed from the beginning of the project to de-identifying all data to protect the privacy and confidentiality of all AF personnel before conducting any analyses. We included a number of independent predictors, covariates and time varying dependent variables. Construction of this complex database turned out to be a much greater challenge than we could have ever anticipated. Our time dependent variables include transitions such as deployment and redeployment as well as changes in an individual's life (e.g. age, occupation, marital status, a change in rank, or a change in location). Going into this project, we knew that ultimately the quality of the database would lie in our ability to (1) Obtain access to numerous AF and Department of Defense Data Sources; (2) Develop a secure process for de-identification of all individual level data and (3) Update critical transitions and changes on individual level on a quarterly basis. It took us the better part of four years to feel confident that we had produced a longitudinal, linked database that is secure, and protects the confidentiality and privacy of all Ar Force personnel. We also have a proven, experienced, well-integrated team that has accomplished this work together, and plans to pursue the next phase of this work together if it were to be funded. We are now extremely well poised to pursue the development of new methodological approaches in suicide research, utilizing this powerful and informative longitudinal data with a cohort that starts in 2003 and can be continually updated. We have accomplished our previous aims related to examining the relationship between the level of implementation of the Air Force Suicide Prevention Program across the entire service and have identified which components of the program appear to have the strongest effect (Knox KL, Pflanz S, Talcott GW, Campise RL, Lavigne JE, Bajorska A, Tu X, Caine ED. The Air Force Suicide Prevention Program: Implications for public health policy. American Journal of Public Health; [Epub ahead of print: May 13, 2010, 10.2105]). We have added data from multiple sources and have the opportunity in the future to utilize new data sources to enhance the database. We now are ideally poised to examine the effects and interactions of individual, community and organizational factors on the risk of suicide in the AF. We propose to do this through developing predictive models, using the implementation of new initiatives in the AF to reduce suicide. Key to these new initiatives is to increase resilience in AF personnel and early identification of high risk AF personnel, still delivered through the framework of a public health model of suicide prevention.