Opgaveforskydning til Forebyggelse af Unges Selvmord

Aktiv komparator: Usual Community Center Services

Deltagerne i denne arm vil fortsætte med at modtage det standard ungdomsprogram og de tjenester, der tilbydes på de deltagende fællesskabshuse. Dette er en individuel session, der fokuserer på aktiv lytning.

Andet: Sædvanlige Fælleshustjenester

Deltagerne i denne arm vil fortsætte med at modtage de standard ungdomsprogrammer og -tjenester, der tilbydes af ungdomsfællesskabscentre, herunder mentoring, akademisk støtte og rekreative aktiviteter. De vil ikke modtage BIPT-A.

Andre navne:

• Sædvanlig pleje
• Standard Ungdomsprogrammering

Eksperimentel: Adapted IPT-A Delivered by Youth Mentors

Participants in this arm will receive 6 weekly sessions of an adapted, brief Interpersonal Psychotherapy for Adolescents (BIPT-A) delivered by trained youth mentors (n=5) at the partnering youth community centers. The intervention focuses on improving interpersonal functioning, communication skills, and supportive relationships to reduce depressive symptoms, low belongingness, and perceived burdensomeness.

Adfærdsmæssigt: Adapted Brief Interpersonal Psychotherapy for Adolescents (IPT-A LAZOS)

Adolescents in this intervention will receive 6 weekly sessions of an adapted brief version of Interpersonal Psychotherapy for Adolescents (BIPT-A), delivered by trained lay providers (i.e., youth mentors) in youth community centers. The adaptation used a community-participatory research approach to culturally and contextually meet the needs of immigrant-origin inner-city adolescents. The adapted intervention keeps core elements (education, affect identification, and interpersonal skills) and bolsters these skills to target belongingness and burdensomeness, which are factors associated with suicide ideation. Sessions follow a structured, manualized approach. The goal is to reduce depressive symptoms, increase sense of belongingness, and decrease perceived burdensomeness among adolescents with subthreshold depression (score between 4-9 in the PHQ-A).

Andre navne:

• IPT-A
• BIPT-A

Feasibility of the intervention

The Feasibility of Intervention Measure (FIM) is a 4-item self-report survey (Weiner et al., 2017) used to assess whether the intervention can be successfully carried out (feasible). The scores for the 4 items are averaged, yielding a total score of 1-5, where 1-2 indicates low perceived feasibility, 3 indicates moderate, and 4-5 indicates high perceived feasibility. In summary, higher scores indicate higher perceived feasibility (a better outcome).

Acceptability of the intervention

The Acceptability and Appropriateness of Intervention Measure (AIM) is an 8-item self-report survey that assesses whether the intervention is satisfactory (acceptability) and relevant (appropriateness). The measure is divided into 4-item subscales: acceptability and appropriateness. These constructs are evaluated separately, with an average score ranging from 1 (low) to 5 (high) (Weiner et al., 2017). Higher scores indicate higher satisfaction (acceptability) and relevance (appropriateness), meaning a better outcome.

Change in depressive symptoms

Depressive symptoms are one of the study's mechanisms of change associated with passive suicide ideation.

Depressive symptoms will be measured with the Patient Health Questionnaire-9 Adolescent version (PHQ-A), a 9-item self-report scale. PHQ-A has been validated with the adolescent and Hispanic populations. Most studies use ≥10 as the cutoff score, indicating clinically significant depressive symptoms among adolescents. The total score is the sum of all 9 items (0-27), where 0-4 is minimal or no depression, 5-9 mild depression, 10-14 moderate depression, 15-19 moderately severe depression, and 20-27 severe depression. In summary, higher scores indicate greater severity of depressive symptoms (a worse outcome).

Change in interpersonal factors associated with passive suicide ideation.

Thwarted Belongingness (TB) and Perceived Burdensomeness (PB) are two factors associated with passive suicide ideation. These two factors are mechanisms of change targeted by the intervention.

The Interpersonal Needs Assessment (INQ-15) measures the extent to which individuals believe they belong (i.e., TB using 9 items) or perceive themselves as a burden to others (i.e., PB using 6 items), which are scored separately, one for TB and one for PB.

Scholars use either the sum score or the average. This study will use mean scores because they preserve the 1-7 scale and provide easier, consistent interpretation. Higher scores indicate higher Thwarted Belongingness and Perceived Burdensomeness (worse outcomes).

Change in anxiety symptoms

Due to the co-occurrence of depressive symptoms with anxiety among adolescents, the investigators will measure anxiety symptoms. The Generalized Anxiety Disorder (GAD-7), a 7-item self-report scale to assess anxiety, will be used to measure anxiety symptoms.

A score of 10 or above typically indicates clinically significant anxiety symptoms and the need for further evaluation. The items (7) are summed, with scores ranging from 0 to 21, where 0-4 indicates minimal anxiety, 5-9 mild anxiety, 10-14 moderate anxiety, and 15-21 severe anxiety. Higher scores indicate greater anxiety severity (a worse outcome).

Change in experiences with discrimination

The Adolescent Discrimination Distress Index (ADDI; Fisher, Scyatta, & Fenton, 2000) is a 15-item measure that assesses adolescent distress in response to perceived instances of racially motivated discrimination in institutional (e.g., stores, restaurants), educational (e.g., teacher evaluations), and peer contexts. It was developed to examine the nature and impact of racial and ethnic discrimination on development in multiethnic samples of youth. Students indicate whether they have experienced each type of discrimination because of their race or ethnicity and, if so, they rate how much it upset them, on a 5-point scale ranging from not at all to extremely. Total score range (15-75 using a sum). Higher scores indicate higher levels of distress (a worse outcome).