Suicide rates for American Indian youth are typically twice those of Caucasian youth; suicide prevention programs for Indian youth have seldom been empirically tested, nor theoretically based. The MAPS (Measure of Adolescent Potential for Suicide) assessment protocol and CAST (Coping And Support Training) program were found to have a significant impact on reducing suicide potential among multi-cultural high-risk youth; this prevention approach needs testing in Indian communities, along with development of culturally relevant family and community-based supportive interventions. Dr. C. June Strickland's career goal is to gain advanced skills and enhance her understanding of community-based prevention research and the cross-cultural translation of nursing theory. Activities to achieve this goal include taking courses, attending conferences/workshops, and implementing a study of suicide prevention with Indian youth.
Specific aims of the study are: 1) To pilot-test the CAST suicide prevention program in rural Indian tribal communities. An experimental design (N=60-30 experimental and 30 control youth) and repeated measures analysis of variance will be used. The central hypothesis is that CAST will be more effective than a control condition (MAPS only) in reducing suicidal behaviors, depression and related risk factors. 2) To determine the cultural sensitivity of CAST. 3) To develop a culturally appropriate family intervention. 4) To inductively derive a culturally appropriate community-level youth suicide prevention Program.
Aims 3 and 4 will be achieved using a grounded theory study design and inductive coding/analysis of interview and focus data from Indian youth, parents and tribal Medicine people. Findings from the 4 aims will set the stage for a full-scale prevention trial to be propsoed in a future R01 application. This grant will prepare Dr. Strickland, an American Indian nurse, to gain advanced skills in prevention science to address a major health concern, youth suicide, for American Indian people. The proposed study is consonant with NINR's priority to test community-based nursing models for underserved populations and addresses on of the six NINR scientific areas of concern: health and risk behaviors.