Expanding the Geospatial Identification of Elevated Suicide Risk (GIESR) Method to Identify Neighborhood Level Risk and Protective Factors for Youth Suicide Ideation and Attempts

项目概要： 自杀是美国青少年死亡的第二大原因。 预防自杀战略呼吁发展社区预防服务， 自杀行为的风险。1然而，我们对社区水平变量的认识存在很大差距 2发展社区自杀预防方法的关键下一步是 确定可修改的目标机制，用于公共卫生干预。我们的目标是 建议是确定与自杀风险相关的可修改的候选机制， 邻里水平。我们的团队已经提出并检验了一种统计方法， 随着社区内自杀意念和企图率的升高， 自杀风险升高（GIESR）。GIESR方法利用常规自杀风险筛查 在医疗机构内进行。GIESR利用电子健康记录数据来绘制患病率 自杀意念和企图在一个定义的地理集水区。对全球经济、社会和文化权利全球倡议的进一步评价 模型，复制和扩展这种方法，将支持识别 青少年自杀意念和企图的邻里水平风险和保护因素。 该项目有两个主要目标：目标1将复制和扩展GIESR方法， 心理测量属性，并创建一个实施指南，使GIESR方法可以独立 被其他人复制和使用，用于发展以社区为基础的自杀预防计划。GIESR 该方法将使用德克萨斯儿童医院的数据进行检查，并绘制青少年自杀风险图。 大休斯顿都会区在目标2中，我们将应用GIESR方法来识别风险和保护 与青年自杀意念和企图率相关的因素。目的2 包括合并多个以公共卫生为重点的数据集，包括社会经济，枪支许可， 犯罪和安全数据，沿着GIESR方法生成的数据，以识别显著风险 以及社区层面自杀的保护因素。 该提案推进了NIMH战略计划目标4战略4.1的目标，即利用“电子 健康记录.以确定改善服务获得、提供和结果的可变目标”，并促进 数据驱动的方法，以确定预防性干预的新目标。 GIESR方法，以确定其他社区的高风险领域，并将为制定 以社区为基础的自杀预防工作，针对已确定的风险和保护因素。

PROJECT SUMMARY: Suicide is the second leading cause of death among adolescents in the United States.16 The National Strategy for Suicide Prevention calls for the development of community preventive services that will reduce the risk for suicidal behaviors.1 Yet there is a substantial gap in our knowledge of community level variables associated with suicide risk.2 A critical next step toward developing community suicide prevention approaches is the identification of modifiable target mechanisms for use in public health interventions. Our objective in this proposal is to identify modifiable candidate mechanisms associated with suicide risk at the neighborhood level. Our team has proposed and examined a statistical method for identifying localized areas with elevated rates of suicidal ideation and attempts within the community, the Geospatial Identification of Elevated Suicide Risk (GIESR) method. The GIESR method capitalizes on routine suicide risk screening conducted within the healthcare settings. GIESR draws on electronic health records data to map the prevalence of suicide ideation and attempts within a defined geographic catchment area. Further evaluation of the GIESR model, to replicate and extend this methodological approach, will support the identification of neighborhood level risk and protective factors for youth suicidal ideation and attempts. The project has two primary aims: Aim 1 will replicate and extend the GIESR method to evaluate its psychometric properties, and to create an implementation guide, so that the GIESR method can be independently replicated and used by others for the development of community-based suicide prevention programs. The GIESR method will be examined using data from Texas Children’s Hospital and mapping youth suicide risk within the greater Houston metropolitan area. In Aim 2, we will apply the GIESR method to identify risk and protective factors associated with rates of youth suicide ideation and attempts at the neighborhood level. Aim 2 includes the merging of multiple public health focused data sets, including socioeconomic, firearm licensing, crime, and safety data, along with data generated by the GIESR method, to allow the identification of salient risk and protective factors for suicide at the community level. This proposal advances the goals of the NIMH Strategic Plan, Goal 4, Strategy 4.1, to utilize “electronic health records… to identify mutable targets for improving service access, delivery, and outcomes” and to promote data-driven approaches to identify novel targets for preventive interventions.15 Findings will inform use of the GIESR method to identify areas of elevated risk in other communities and will inform the development of community-based suicide prevention efforts targeting identified risk and protective factors.