Suicide Prevention Study

Wexler, Lisa

Abstract

The role of social determinants is evident in the disproportionately high rates of Alaska Native (AN) youth suicide that when aggregated across a rural area, can be 18 times higher than the U.S. youth general population for ages 15-19 (124 vs 6.9/ per 100,000). Despite their importance, little is yet known about the community-level resilience and protective processes that rural AN communities enact to protect their youth. Our research seeks to identify the pathways from these larger social and community processes as they individual, youth resilience from suicide, in order to inform a wide variety of prevention efforts with AN youth. The proposed study will use a collaborative mixed methods approach to: (a) identify mutable community-level protective factors that appear to impact youth suicide; (b) test the role of community protective factors and mechanisms, in a multi-level model of youth suicide resilience; and (c) develop and disseminate a practical tool to assess and strengthen community-level protection and reduce suicide risk and increase youth resilience. The Alaska Native Resilience Research Study (ANRRS) has the following specific aims: 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, moderated by a set of community-level 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 these community-level factors to enhance their protective capabilities to increase youth health and reduce the risk for suicide. To conduct the proposed suicide prevention study our team will work with our long-term community research partners in the three Alaska regions with the highest suicide rates: Northwest Arctic, Norton Sound, and Yukon Kuskokwim. As the research progresses, we will share preliminary results with the Alaska Native Collaborative Hub for Resilience Research (ANCHRR) to ensure its relevance throughout Alaska and will disseminate the resulting AK-CRM tool throughout the state. The integration of tribal knowledge and participation in this research will address local needs while maximizing the study?s public health impact. The goal of this work is to identify vital community-level targets that can most effectively contribute to the reduction of youth suicide risk and promote resilience. Our approach will offer a culturally-responsive method for community members to document and bolster their strengths in ways that reflect community priorities, epistemologies, ontologies, and practices, contributing to sustainable solutions for suicide prevention