The overall goal of the Southwest Hub for American Indian Youth Suicide Prevention Research (Southwest Hub) is to establish a collaborative network of tribal leaders, investigators, interventionists, service providers and service users in the Southwest region that will be managed by trusted scientific partner--Johns Hopkins Center for American Indian Health (CAIH)--to pool intellectual resources, cultural assets and experience to overcome American Indian and Alaska Native (AIAN) youth suicide disparity. Primary goals are to: 1) develop and test preventive strategies that can sustainably reduce the burden of youth suicide and promote resilience in Native communities; 2) conduct outreach and dissemination to promote additional tribal community engagement in research activities; and, 3) enable tribal leaders, providers and policy makers to used science-based information to formulate mental health policies and programs to reduce suicide.
Specific aims are:
Aim 1) Develop an Administrative Core to support communication, coordination of activities and capacity building to facilitate, produce and share evidence to prevent youth suicide and promote resilience, and apply relevant findings in Hub partners? settings (White Mountain Apache, Navajo, San Carlos Apache, Hualapai and Cherokee Nations), and in additional interested tribal communities through collaboration with other regional Hubs and national allies.
Aim 2) Undertake a rigorous Suicide Prevention Study to test a sequence of novel preventive strategies that can be used by tribes to sustainably reduce the burden of AI youth suicide and promote resilience. A key priority will be to demonstrate the effectiveness of task-shifting intervention administration to culturally embedded paraprofessional community mental health workers (CMHWs). In the White Mountain Apache setting, the primary research site for this Hub, we will build on a line of youth suicide prevention research that the Tribe and CAIH have undertaken since 1994. It includes a robust tribally-mandated suicide surveillance and follow-up system run by Apache CMHWs that is in early stages of replication by Navajo Nation, the secondary research site for this Hub. The tribal-specific surveillance systems will aid the research teams in monitoring trends and patterns in self-harm prior to, during and after the grant period; offer a unique means to recruit community-based samples of suicidal Native youth; and provide a platform for testing strategies to prevent youth suicide and promote resilience. For collaborators in the three satellite sites (San Carlos Apache, Hualapai, and Cherokee Nations), the development of parallel surveillance systems, research skills and prevention interventions will be determined based on local policy and service priorities.
Aim 3) Conduct outreach and disseminate science-based information for tribal leaders and allied partners, including other Hubs, to formulate mental health policies and programs to reduce youth suicide across diverse tribal settings. The Southwest Hub builds on a 30+-year track record of public health research between Johns Hopkins CAIH, the White Mountain Apache Tribe and Navajo Nation. These partners are poised to extend trusted research relationships to new tribal partners, produce novel evidence, exercise tribal sovereignty to improve public health, and tap extensive national networks to share methods to reduce youth suicide disparity and promote new understanding of youth resilience.
The Southwest Hub for American Indian Suicide Prevention Research will use established tribal suicide surveillance systems to identify and deliver risk reduction and resilience promotion interventions to suicidal youth. Hub partners will evaluate two interventions delivered by culturally embedded paraprofessionals in sequence to 1) reduce immediate risk of suicide and connect youth to treatment; and 2) promote long-term resilience through structured Elders? training. The Hub builds on 30+-year productive research partnership between Johns Hopkins, White Mountain Apache Tribe and Navajo Nation, now extending to San Carlos Apache, Hualapai and Cherokee Nations, who together will use Hub findings to design suicide prevention policy and practice across diverse settings.
