Suicide Prevention for Sexual and Gender Minority Youth

项目摘要 自杀是所有美国公民死亡的第十大原因，也是美国公民死亡的第二大原因。 15至29岁的青年和新生儿。一个特别容易自杀的群体 性和性别少数群体（SGM）。SGM是一个总括性术语，用于描述以下个人： 非排他性的异性恋（例如，男同性恋、女同性恋、双性恋）和/或作为跨性别者/非二元（例如，识别为 性别与出生性别不同）。事实上，2017年美国代表性的最新调查结果强调了惊人的事实 性少数和异性恋青少年之间自杀倾向的差异，23%的性少数青少年 报告有一次或多次自杀企图的青年（在过去12个月内），而异性恋青年的比例为5.4%。患病率 与一般情况相比，性别少数群体中的终身自杀企图率也大幅上升。 在18-24岁的跨性别人群中，45%的人报告有一次以上的自杀企图史。 尽管SGM青年/新兴成年人自杀的健康差异很大，但没有已知的自杀事件。 为这一高度脆弱的人群制定了预防方案。鉴于文献中的这一关键空白， 拟议的研究将调整和测试一种创新的干预措施，将患者导航与安全性相结合。 针对SGM青年/新兴成年人的规划干预（PN+SPI），旨在针对机制（例如，减少 在理论上是自杀的基础。如果 PN+SPI干预对预期目标显示出具有临床意义的影响（即，减少阻碍 在开放期试验（R61期）期间， 如果我们认为这是可行和可接受的，我们将随后进入R33阶段。在R33阶段，我们将进行试点 PN+SPI的随机对照试验，将其与单独的SPI进行比较，以评估可行性、可接受性和 初步疗效。在随机对照试验中，我们将对170名年轻人和新生儿进行抽样， 成人SGMs，我们还将通过纵向研究评估PN+SPI干预的作用机制。 分析.拟议的项目具有重大的公共卫生意义，因为SGM是最脆弱的人群之一 全球自杀组织。鉴于PN+SPI干预的简短性及其对安全规划的强调 和获取社区资源，PN+SPI干预具有广泛传播的高潜力， 公共卫生影响。

PROJECT SUMMARY Suicide is the 10th leading cause of death among all U.S. citizens and is the 2nd leading cause of death among youth and emerging adults between the ages of 15 and 29. One group that is particularly vulnerable to suicide is sexual and gender minorities (SGMs). SGM is an umbrella term used to describe individuals who identify as non-exclusively heterosexual (e.g., gay, lesbian, bisexual) and/or as transgender/non-binary (e.g., identify as a gender different from their birth sex). Indeed, recent U.S. representative findings from 2017 underscore striking disparities in suicidality between sexual minority and heterosexual adolescents, with 23% of sexual minority youth reporting one or more suicide attempts (in the past 12 months) vs. 5.4% of heterosexual youth. Prevalence of lifetime suicide attempts among gender minorities is also substantially elevated compared to the general population, with 45% of 18-24-year-old transgender individuals reporting a history of one more suicide attempts. Despite these substantial health disparities in suicide among SGM youth/emerging adults, no known suicide prevention programs exist for this highly vulnerable population. Given this crucial gap in the literature, the proposed study will adapt and test an innovative intervention that integrates patient navigation with the Safety Planning Intervention (PN+SPI) for SGM youth/emerging adults designed to target mechanisms (e.g., reductions in thwarted belongingness and increases in suicide-related coping skills) that theoretically underlie suicide. If the PN+SPI intervention displays a clinically meaningful effect on the purported targets (i.e., reductions in thwarted belongingness and increases in suicide-related coping skills) during the open-phase trial (R61 phase) and is feasible and acceptable, we will subsequently move to the R33 phase. In the R33 phase, we will conduct a pilot randomized controlled trial of the PN+SPI by comparing it to SPI alone to assess feasibility, acceptability, and preliminary efficacy. During the randomized controlled trial, in which we will sample 170 youth and emerging adult SGMs, we will also evaluate the mechanisms of action of the PN+SPI intervention through longitudinal analysis. The proposed project has substantial public health significance as SGMs are one of the most vulnerable groups for suicidality globally. Given the brevity of the PN+SPI intervention and its emphasis on safety planning and accessing community resources, the PN+SPI intervention has high potential for wide dissemination and public health impact.