Suicide prevention as a community development process: understanding circumpolar youth suicide prevention through community level outcomes
James Allen, Gerald Mohatt, Carlotta Ching Ting Fok, David Henry, People Awakening Team, Catherine Agayar, Fred Augustine, Mary Augustine, Paula Ayunerak, Theresa Damian, Lawrence Edmund Sr, Barbara Joe, Lucy Joseph, Joe Joseph, Placide Joseph, Zacheus Paul, Charlotte Phillp, Henry Phillip, Joe Phillip, Penny Alstrom, Fred Augustine, Mary Augustine, Paula Ayunerak, Theresa Damian, Shelby Edmund, Flora Patrick, Dennis Sheldon, Isidore Shelton, Catherine Agayar, Theresa Damian, Freddie Edmund, Shelby Edmund, Josie Edmund, Flora Patrick, Martha Simon, Moses Tulim, Ed Adams, Tammy Aguchak, Paula Ayunerak, Sebastian Cowboy, Lawrence Edmunds, Margaret Harpak, Charles Moses, Raymond Oney, Walkie Charles, Richard Katz, Mary Sexton, Lisa Rey Thomas, Beti Thompson, Edison Trickett, Debbie Alstrom, Rebekah Burkett, Diana Campbell, Arthur Chikigak, Gunnar Ebbesson, John Gonzalez, Nick Hubalik, Joseph Klejka, Charles Moses, Dora Nicholai, Eliza Orr, Marvin Paul, Michelle Dondanville, Jonghan Kim, Rebecca Koskela, Johanna Herron, Stacy Rasmus, James Allen, Gerald Mohatt, Carlotta Ching Ting Fok, David Henry, People Awakening Team, Catherine Agayar, Fred Augustine, Mary Augustine, Paula Ayunerak, Theresa Damian, Lawrence Edmund Sr, Barbara Joe, Lucy Joseph, Joe Joseph, Placide Joseph, Zacheus Paul, Charlotte Phillp, Henry Phillip, Joe Phillip, Penny Alstrom, Fred Augustine, Mary Augustine, Paula Ayunerak, Theresa Damian, Shelby Edmund, Flora Patrick, Dennis Sheldon, Isidore Shelton, Catherine Agayar, Theresa Damian, Freddie Edmund, Shelby Edmund, Josie Edmund, Flora Patrick, Martha Simon, Moses Tulim, Ed Adams, Tammy Aguchak, Paula Ayunerak, Sebastian Cowboy, Lawrence Edmunds, Margaret Harpak, Charles Moses, Raymond Oney, Walkie Charles, Richard Katz, Mary Sexton, Lisa Rey Thomas, Beti Thompson, Edison Trickett, Debbie Alstrom, Rebekah Burkett, Diana Campbell, Arthur Chikigak, Gunnar Ebbesson, John Gonzalez, Nick Hubalik, Joseph Klejka, Charles Moses, Dora Nicholai, Eliza Orr, Marvin Paul, Michelle Dondanville, Jonghan Kim, Rebecca Koskela, Johanna Herron, Stacy Rasmus
Abstract
Objectives: Community-based models have become increasingly prominent in prevention, and have special relevance for suicide prevention in circumpolar Indigenous communities. It follows that outcomes from circumpolar suicide prevention programs might be more completely understood at the community level. We present here a methodology for analysis at this level. This paper seeks to understand a cultural prevention program for rural Yup'ik youth in Alaska targeting suicide and co-occurring alcohol abuse as a community development process through changes at the community level.
Study design: Quasi-experimental design with assessment at pre- and post-intervention or at 4 time points. The community development process for this project began in October 2004. The first program baseline assessment began in November 2006, prior to prevention activities with youth and parents, and the post-intervention assessment concluded in March 2008.
Methods: Five key informants pre- and post-intervention completed a community readiness assessment, which is a structured procedure assessing a community's awareness of suicide as an issue and its, organizational readiness for prevention programming. Forty-three adult caregivers or sponsors of youth in the prevention program completed an assessment of behaviours that contributed to community protective factors from youth suicide and alcohol abuse at 4 time points before, during and after the intervention. The 54 youth who participated in the prevention program completed an assessment of community protective factors, also at 4 time points before, during and after the intervention. The community protective factors from suicide that were assessed included safety, enforcement of alcohol prohibitions, role models, support and opportunities for youth.
Results: Community readiness for the prevention efforts increased to new developmental stages of readiness post-intervention, and a trend in the data suggested community protective factors increased in the amount of protective behaviours performed by adults (slope estimate = 0.0162, 95% CI--0.0028-0.0351, d=.55) and in the perceptions of youth (slope estimate=0.0148, 95% CI--0.0004-0.0291, d=.45), in a dose response relationship to the number of prevention program sessions attended by adults and youth.
Conclusions: Using data from a feasibility study, this paper demonstrates the feasibility and potential utility of methodological approaches that use community-level variables beyond individual level outcomes in circumpolar suicide prevention research.
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Source: PubMed