The Senior Connection

描述（由申请人提供）：迫切需要采取干预措施，减少晚年自杀的风险。美国的老年人自杀率最高，也是人口增长最快的部分。我们可以预见，在未来几十年内，死于自杀的老年人数量将大幅增加。本申请是对RFA-CE-10-006的回应。与疾病预防控制中心通过促进连通性来减少自杀的关键战略相一致，我们的长期目标是通过利用老龄化服务提供者网络（ASPN）的资源和专业知识来减少晚年自杀相关的发病率和死亡率，以解决社区居住老年人未满足的社会需求。本研究的目的是：（1）通过退休和老年志愿者计划（RSVP）研究将社交脱节的老年人与同伴支持联系起来是否能有效降低自杀风险;（2）测试人际自杀理论所提供的社交脱节与自杀意念和行为之间的关联的假设机制。 我们将招募400名60岁以上的初级保健患者（200名男性和200名女性），他们认同孤独感和/或好像他们是他人的负担。他们将被随机分配到两个条件之一。那些被分配到高级连接（TSC）的人将与同伴配对，或者，如果他们喜欢并且符合条件，将通过RSVP接受培训并作为他人的同伴。对照组将不接受进一步干预（“照常治疗”[CAU]）。将对受试者进行长达24个月的随访，并重复进行家庭（基线、12和24个月）和电话评估（3、6和18个月）。 本研究有四个具体目的：（1）比较TSC和CAU对老年初级保健患者社会联系的影响;（2）比较TSC和CAU在减少与自杀行为近端风险相关因素方面的有效性;（3）确定老年人社会联系测量的变化是否介导社会联系和自杀风险之间的关系;以及（4）检查对干预的反应是否因性别而异。 公共卫生相关性：退休和老年志愿者方案由社会服务机构在全国各社区提供，这些机构致力于维持老年人的独立性和生活质量。他们的专业知识和资源非常适合减少晚年的自杀风险。如果RSVP被证明在减少自杀意念和增加连通性方面是有效的，它将很容易在老龄化服务提供商网络中传播，作为预防高危老年人自杀的一种手段。

DESCRIPTION (provided by applicant): There is a pressing need for interventions that reduce risk for suicide in later life. Older adults in the U.S. have the highest rate of suicide and are the fastest growing segment of the population. We can anticipate a large rise in the number of older adults who die by suicide in coming decades. This application is in response to RFA-CE-10-006. Consistent with the CDC's key strategy of reducing suicide by promoting connectedness, our long-term goal is to reduce late life suicide-related morbidity and mortality by leveraging the resources and expertise of the aging services provider network (ASPN) to address unmet social needs of community-dwelling older adults. Our objectives with this proposal are (1) to examine whether linking socially disconnected seniors with peer supports through the Retired and Senior Volunteer Program (RSVP) is effective in reducing risk for suicide, and (2) to test an hypothesized mechanism for the association of social disconnectedness and suicidal ideation and behavior informed by the Interpersonal Theory of Suicide. We will recruit 400 primary care patients (200 men and 200 women) over age 60 years who endorse feeling lonely and/or as if they are a burden on others. They will be randomly assigned to either of two conditions. Those assigned to The Senior Connection (TSC) will either be paired with a peer companion or, if they prefer and are eligible, be trained and placed as a peer companion for others by RSVP. The comparison group will receive no further intervention ("care-as-usual" [CAU]). Subjects will be followed for up to 24 months with repeated in-home (baseline, 12, and 24 months) and telephone assessments (3, 6, and 18 months). The study has four specific aims: (1) To compare the impact of TSC and CAU on social connectedness of older adult primary care patients; (2) to compare the effectiveness of TSC and CAU in reducing factors associated with proximal risk for suicidal behavior; (3) to determine if changes in measures of older adults' social connectedness mediate the relationship between social connectedness and suicide risk; and (4) is to examine whether responsiveness to the intervention differs by gender. PUBLIC HEALTH RELEVANCE: The Retired and Senior Volunteer Program (RSVP) is offered in communities nationwide by social service agencies that are dedicated to maintaining the independence and quality of life of older adults. Their expertise and resources are well suited to the reduction of suicide risk in later life. If RSVP is shown to be effective in reducing suicidal ideation and increasing connectedness, it will be easily disseminated across the aging services provider network as a means to prevent suicide among seniors at risk.