BeWel: Suicide Intervention for Alaska Native Youth
Study Details
Study Description
Brief Summary
Two interventions will be delivered virtually to American Indian/Alaska Native youth who have been hospitalized with suicidal attempt, suicidal ideation, or associated risk behaviors, including alcohol-related injury.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
The investigators will conduct a randomized controlled trial whereby Alaska Native (AN) youth who are hospitalized for suicide risk will be randomly assigned to either Qungasvik/Tools for Life or Tools for Life + Motivational Interviewing Social Network (MISN) intervention after their baseline survey, and followed up at 3-, 6-, and 12 months. All youth will receive Tools for Life. Half of the youth will also receive MISN in addition to Tools for Life, along with two 30-minute virtual booster sessions (at 2- and 6-weeks post intervention) focused on connectivity to culture and obtaining support from intergenerational social networks in their home communities. Both interventions will be delivered virtually by a wellness team comprised of Alaska Native community behavioral health aides, prevention specialists and/or Elders who function in their communities as natural healers.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Tools for Life All youth will receive the Tools for Life or Qungasvik intervention. Tools for Life is an evidence-based, community-developed intervention focused on providing protective cultural experiences for Alaska Native youth to address suicide risk and alcohol use. |
Behavioral: Tools for Life
Tools for Life focuses on empowering youth to learn more about their culture and their identity.
|
| Active Comparator: Tools for Life + Motivational Interviewing Social Network intervention (MISN) Half of the youth will will also receive MISN in addition to the Tools for Life intervention. MISN is an evidence-based treatment that augments motivational interviewing with personal social network composition and structure visualization as a means to cultivating healthy social networks and cultural worlds. |
Behavioral: Tools for Life + MISN
Tools for Life focuses on empowering youth to learn more about their culture and their identity. MISN focuses on helping youth get support from their community and social networks.
|
Outcome Measures
Primary Outcome Measures
- Suicide intent/risk [Change from baseline to 3 months]
We will use the Suicidal Ideation Attributes Scale (SIDAS) [0 = Never, 10 = Always]
- Suicide intent/risk [Change from baseline to 6 months]
We will use the Suicidal Ideation Attributes Scale (SIDAS) [0 = Never, 10 = Always]
- Suicide intent/risk [Change from baseline to 12 months]
We will use the Suicidal Ideation Attributes Scale (SIDAS) [0 = Never, 10 = Always]
- Depression [Change from baseline to 3 months]
Patient Health Questionnaire (PHQ-9) [0 -not at all to 3-nearly every day]
- Depression [Change from baseline to 6 months]
Patient Health Questionnaire (PHQ-9) [0 -not at all to 3-nearly every day]
- Depression [Change from baseline to 12 months]
Patient Health Questionnaire (PHQ-9) [0 -not at all to 3-nearly every day]
- Anxiety [Change from baseline to 3 months]
Generalized Anxiety Disorder scale (GAD-7) [0 -not at all to 3-nearly every day]
- Anxiety [Change from baseline to 6 months]
Generalized Anxiety Disorder scale (GAD-7) [0 -not at all to 3-nearly every day]
- Anxiety [Change from baseline to 12 months]
Generalized Anxiety Disorder scale (GAD-7) [0 -not at all to 3-nearly every day]
- Frequency of alcohol use [Change from baseline to 3 months]
Number of days used in the past 30 days. [ 0 to 30]
- Frequency of alcohol use [Change from baseline to 6 months]
Number of days used in the past 30 days [ 0 to 30]
- Frequency of alcohol use [Change from baseline to 12 months]
Number of days used in the past 30 days [ 0 to 30]
- Alcohol use consequences [Change from baseline to 3 months]
Number of times in the past 3 months youth experience 4 different alcohol consequences [0 = Never to 6 = 20 or more times]
- Alcohol use consequences [Change from baseline to 6 months]
Number of times in the past 3 months youth experience 4 different alcohol consequences [0 = Never to 6 = 20 or more times]
- Alcohol use consequences [Change from baseline to 12 months]
Number of times in the past 3 months youth experience 4 different alcohol consequences [0 = Never to 6 = 20 or more times]
Secondary Outcome Measures
- Sobriety self-efficacy [Change from baseline to 3 months]
Three items ask how sure youth are about staying sober from alcohol from 1= def drink to 5 = def not drink
- Sobriety self-efficacy [Change from baseline to 6 months]
Three items ask how sure youth are about staying sober from alcohol from 1= def drink to 5 = def not drink
- Sobriety self-efficacy [Change from baseline to 12 months]
Three items ask how sure youth are about staying sober from alcohol from 1= def drink to 5 = def not drink
- Intentions to be sober from alcohol [Change from baseline to 3 months]
Youth report on intentions to be sober in the next 6 months from 1 = def yes to 4 = def no
- Intentions to be sober from alcohol [Change from baseline to 6 months]
Youth report on intentions to be sober in the next 6 months from 1 = def yes to 4 = def no
- Intentions to be sober from alcohol [Change from baseline to 12 months]
Youth report on intentions to be sober in the next 6 months from 1 = def yes to 4 = def no
- Social network composition [Change from baseline to 3 months]
Participants will be asked to name 15 contacts ("alters") who are at least 18 years of age. Participants will rate each of the 15 people on the same set of questions with categorical response options (about demographics, relationship quality, likelihood to use drugs, etc.). For each participant, the selected responses will be summed across all of the network alters and divided by 15 to produce network composition percentages of the whole set of alters named by the participant (% of AI/ANs, % who engage in heavy drinking).
- Social network composition [Change from baseline to 6 months]
Participants will be asked to name 15 contacts ("alters") who are at least 18 years of age. Participants will rate each of the 15 people on the same set of questions with categorical response options (about demographics, relationship quality, likelihood to use drugs, etc.). For each participant, the selected responses will be summed across all of the network alters and divided by 15 to produce network composition percentages of the whole set of alters named by the participant (% of AI/ANs, % who engage in heavy drinking).
- Social network composition [Change from baseline to 12 months]
Participants will be asked to name 15 contacts ("alters") who are at least 18 years of age. Participants will rate each of the 15 people on the same set of questions with categorical response options (about demographics, relationship quality, likelihood to use drugs, etc.). For each participant, the selected responses will be summed across all of the network alters and divided by 15 to produce network composition percentages of the whole set of alters named by the participant (% of AI/ANs, % who engage in heavy drinking).
- Social network structure [Change from baseline to 3 months]
Participants will rate the relationship strength between each of the 15 named alters. For each alter pair participants will rate if the two people know each other and, if yes, have individuals connected recently. Measures of network structure (i.e., network "connectedness") will be constructed from the set of evaluations for each participant. For example, network "density" will be constructed for the network overall, which is calculated by summing the number of alter pairs who know each other and dividing by the total number of possible ties among 15 alters (105). Individual alter "centrality" will be calculated by summing the number of connections each individual alter has with other alters in the network.
- Social network structure [Change from baseline to 6 months]
Participants will rate the relationship strength between each of the 15 named alters. For each alter pair participants will rate if the two people know each other and, if yes, have individuals connected recently. Measures of network structure (i.e., network "connectedness") will be constructed from the set of evaluations for each participant. For example, network "density" will be constructed for the network overall, which is calculated by summing the number of alter pairs who know each other and dividing by the total number of possible ties among 15 alters (105). Individual alter "centrality" will be calculated by summing the number of connections each individual alter has with other alters in the network.
- Social network structure [Change from baseline to 12 months]
Participants will rate the relationship strength between each of the 15 named alters. For each alter pair participants will rate if the two people know each other and, if yes, have individuals connected recently. Measures of network structure (i.e., network "connectedness") will be constructed from the set of evaluations for each participant. For example, network "density" will be constructed for the network overall, which is calculated by summing the number of alter pairs who know each other and dividing by the total number of possible ties among 15 alters (105). Individual alter "centrality" will be calculated by summing the number of connections each individual alter has with other alters in the network.
- Time spent around peers who use alcohol [Change from baseline to 3 months]
Participants will report on how much time is spent around peers who drink from 0 = never to 3 = often
- Time spent around peers who use alcohol [Change from baseline to 6 months]
Participants will report on how much time is spent around peers who drink from 0 = never to 3 = often
- Time spent around peers who use alcohol [Change from baseline to 12 months]
Participants will report on how much time is spent around peers who drink from 0 = never to 3 = often
- Awareness of connectedness [Change from baseline to 3 months]
Youth report on feelings of connectedness to community, family and environment from 1 = strongly agree to 5 strongly disagree
- Awareness of connectedness [Change from baseline to 6 months]
Youth report on feelings of connectedness to community, family and environment from 1 = strongly agree to 5 strongly disagree
- Awareness of connectedness [Change from baseline to 12 months]
Youth report on feelings of connectedness to community, family and environment from 1 = strongly agree to 5 strongly disagree
- Community protective factors [Change from baseline to 3 months]
Youth Community Protective Factors Scale. Youth report on feelings about different protective factors from 1 = strongly agree to 5 strongly disagree
- Community protective factors [Change from baseline to 6 months]
Youth Community Protective Factors Scale Youth report on feelings about different community protective factors from 1 = strongly agree to 5 strongly disagree
- Community protective factors [Change from baseline to 12 months]
Youth Community Protective Factors Scale Youth report on feelings about different community protective factors from 1 = strongly agree to 5 strongly disagree
- Individual protective factors [Change from baseline to 3 months]
Youth report on feelings about different individual protective factors from 1 = strongly agree to 5 strongly disagree
- Individual protective factors [Change from baseline to 6 months]
Youth report on feelings about different individual protective factors from 1 = strongly agree to 5 strongly disagree
- Individual protective factors [Change from baseline to 12 months]
Youth report on feelings about different individual protective factors from 1 = strongly agree to 5 strongly disagree
- Reasons for life [Change from baseline to 3 months]
Brief Reasons for Life Scale from 1 not at all important to 5 very important
- Reasons for life [Change from baseline to 6 months]
Brief Reasons for Life Scale from 1 not at all important to 5 very important
- Reasons for life [Change from baseline to 12 months]
Brief Reasons for Life Scale from 1 not at all important to 5 very important
- Reflective processes [Change from baseline to 3 months]
The Reflective Processes scale taps a culturally patterned type of awareness and youth report from from 1 = strongly agree to 5 strongly disagree
- Reflective processes [Change from baseline to 6 months]
The Reflective Processes scale taps a culturally patterned type of awareness and youth report from from 1 = strongly agree to 5 strongly disagree
- Reflective processes [Change from baseline to 12 months]
The Reflective Processes scale taps a culturally patterned type of awareness and youth report from from 1 = strongly agree to 5 strongly disagree
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Self-identify as Alaska Native youth
-
Between the ages of 15 and 24
-
Admitted to the hospital for suicide attempt, ideation, or associated risk behaviors including alcohol-related injury or acute intoxication
Exclusion Criteria:
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Yukon-Kuskokwim Health Corporation | Bethel | Alaska | United States | 99559 |
| 2 | Tanana Chiefs Conference | Fairbanks | Alaska | United States | 99559 |
Sponsors and Collaborators
- RAND
- Patient-Centered Outcomes Research Institute
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- YY46Q97AEZA8