Alaska Native Resilience Research Study
试验速览
- 阶段
- 不适用
- 入组人数
- 585
- 主要终点
- Community Level Assessment: suicide and accidental deaths
研究概览
简要总结
The goal of the Alaska Native Resilience Research Study (ANRRS) is to identify community-level protective factors that can most effectively reduce co-occurring youth suicide and alcohol risk. The following specific aims will help us achieve this overarching goal. The research team will: (1): Assess the association of a set of modifiable cultural, community and institutional factors (protective community factors) with suicide, suicidal behaviors (ideation, attempt), and associated adverse outcomes (accidental death, alcohol-misuse requiring healthcare) in 64 rural and remote Alaska Native villages to identify community-level factors that are most predictive of youth health outcomes; (2): In a stratified random sample of six communities, use quantitative methods to test a multi-level model of individual-level youth protective factors as predictors of individual-level youth resilience from suicide risk outcomes; and (3): Develop and disseminate a method-Alaska Community Resilience Mapping (AK-CRM)-for communities to measure and strategically strengthen their protective capabilities to increase youth health and reduce the risk for suicide.
Methodology:
详细描述
The ANCHRR builds on our established tribal partnerships in the three regions of Alaska with the highest need for effective, culturally congruent and community-based suicide prevention. Drs. Rasmus and Allen have been working collaboratively with Yup'ik communities in the Yukon Kuskokwim region and Dr. Wexler has been doing community-based participatory research in Northwest Alaska (NWA) for 20 years. Both research teams have spent this time partnering with tribal communities and developing evidence-based and self-determined suicide prevention initiatives that reflect local, AN understandings and values, strengthen community systems of support, and build local capacity for strategic prevention practice. The collaborative hub will extend this successful partnership model to include all of the tribal health regions across the state. With relevance for all of rural Alaska, the Alaska Native Resilience Study will provide important insights into the community level factors-institutions, traditions, resources and leaders-and mechanisms-the community perceptions, practices and norms-that increase resilience from suicide and reduce risk. The resulting Alaska Community Resilience Mapping (AK-CRM) Tool will provide a user-friendly, visual representation of the community-level protective factors and processes, and will engage Alaska community members in identifying the community-level protective factors in their community and will offer scientifically-based recommendations for action. In this way, ANCHRR's proposed activities translate results from the research study into practical suggestions for tribal leaders, local practitioners and policy makers, to maximize its public health impact.
研究设计
- 研究类型
- Observational
- 观察模型
- Ecologic Or Community
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 15 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •To identify persons able to assess diverse community protective factors, we will identify at least 5 village members from each community who are: (a) local school board members or school workers, (b) community health aids, (c) village-based counselors, (d) tribal council members or tribal administrators, (e) city managers, (f) village public safety officers or village public officers, (g) postmasters, (h) Elder council members, and/or (i) religious leaders. This initial village list will also include other people who are informal leaders in the village.
- •Exclusion: From this list, participants will be screened to ensure: (1) village residence or service provision in the community for at least 5 years cumulatively and (2) endorsements from members of the Research Steering Committee, who are knowledgeable about specific community dynamics.
- •The sample of 64 communities will be stratified into higher, medium and lower protection community groups using their protective community factor score from Aim 1, then 6 communities will be randomly selected, 2 from each stratification group.
- •Children in each of 6 selected communities
- •All adults 18-29 in 6 selected communities.
- •Approximately 15 individual adults will be recruited in each of the six villages (n=60) through sampling the following sectors of community: government, church, social service, store/business, school, health care, parent, elder. We will contact individuals nominated in each sector by the local tribal council or their designate.
排除标准
- •Communities with fewer than 150 people will be excluded since the protective community dynamics and adverse outcomes are more stable in larger villages. This reduces the number of participating communities from 71 total number of villages to
- •We will exclude children under the age of 15, because we seek information regarding late adolescence and beginning adulthood. We will exclude children who do not have the capacity to assent or to participate in the computerized survey.
- •We will exclude adults who do not have the capacity to consent or to participate in the computerized survey.
- •We will exclude adults who have lived in their respective village for less than 5 years, because we will be asking for information about community factors that require perspectives over time. We will exclude adults who do not have the capacity to consent or to participate in the computerized survey.
结局指标
主要结局
Community Level Assessment: suicide and accidental deaths
时间窗: Year 2
The Trauma Registry and the Alaska Violent Death Reporting System (AKVDRS) will be used to document suicide and accidental deaths
次要结局
- Individual Level Assessment: Youth: Individual: Communal Mastery Scale(Year 4)
- Individual Level Assessment: Suicide Risk Resilience: Reasons for Life(Year 4)
- Individual Level Assessment: Alcohol Risk: Reflective Processes Resilience: Reflective Processes(Year 4)
- Individual Level Assessment: Youth: Community: Community Protective Factors(Year 4)
- Individual Level Assessment: Youth: Social Connection: Awareness of Connectedness(Year 4)
- Individual Level Assessment: Adult: Protective Community Factors: Protective Community Factors(Year 4)
- Individual Level Assessment: Adult: Community Social Processes: Informal Social Control(Year 4)
- Individual Level Assessment: Youth: Family: Family Relationship Scale(Year 4)
- Community Level Assessment: Community Protective Factors(Year 2)
研究者
Stacy Rasmus
Research Associate Professor
University of Alaska Fairbanks