Suicide death rates for indigenous Hawaiians are amongst the highest in the world for youth, taking a tremendous toll on local communities. Such tragic moments can be filled with darkness, confusion, doubt and uncertainty, contributing to contagion, further suffering and feelings of hopelessness among youth, their families, and the community. Influenced by community support and understanding as well as a sense of belonging and cultural respect, our indigenous Hawaiian youth and families have demonstrated resilience. Programs that build on these strengths through learning about their cultural values and practices show promise. Effective suicide prevention for rural and indigenous youth requires a broad-based community commitment and connection. Comprehension of local, community perspectives of suicide and well-being enhances the knowledge of existing evidence that suicide determinants are valid for rural youth. Our long- range is to integrate community wisdom with scientific methods to conduct youth suicide prevention research that mitigates health disparities and improves the wellbeing of indigenous Hawaiian youth and their communities. Our overall objective is to develop and demonstrate a culturally-responsive youth suicide prevention program that has a positive impact in a Native Hawaiian community. The Building Strengths and Inspiring Hope among Youth and their Communities Project will use a community engaged approach and cultural knowledge and practices to inform the selection, adaptation, development and evaluation of a viable, multi-faceted youth suicide prevention strategy.
The specific aims are to: adapt and develop the components for youth suicide prevention intervention, and refine the intervention methodology to align with these adaptations (Aim 1: Culturally-Tailor Intervention); and to conduct a randomized community study to evaluate and compare the effects of gatekeeper training and an integrated program, the Caring Communities for Youth Suicide Prevention in increasing wellness; suicide prevention skills, including recognition of risk and protective factors, and warning signs of a person at-risk for suicide; increasing competence in dealing with suicide events; and decreasing stigma related to discussing suicide and seeking mental health care services (Aim 2: Intervention Research). This 2-year developmental project is a translational, demonstration research study in behavioral and clinical health advancing knowledge in health inequity and disparities among Native Hawaiians for youth suicide by comparing two types of community-based interventions in a regression point displacement design. We will use a randomized community, superiority trial to evaluate the Caring Communities for Youth Suicide Prevention Program (integrated and multifaceted) with gatekeeper training alone. We expect to improve the synergy between evidence interventions and culturally-informed, community- based youth programs, and improve youth and community wellness, advancing the knowledge about and availability of more culturally relevant suicide prevention interventions for indigenous communities.
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