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.
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 and two 30-minute virtual follow-up visits (at 2- and 6-weeks post intervention) focused on connectivity to culture and obtaining support from intergenerational social networks in their home communities. Half of the youth will also receive MISN in addition to Tools for Life. 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 Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
302
Tools for Life focuses on empowering youth to learn more about their culture and their identity.
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.
Yukon-Kuskokwim Health Corporation
Bethel, Alaska, United States
Tanana Chiefs Conference
Fairbanks, Alaska, United States
Suicide intent/risk
We will use the Suicidal Ideation Attributes Scale (SIDAS) \[0 = Never, 10 = Always\]
Time frame: Change from baseline to 3 months
Suicide intent/risk
We will use the Suicidal Ideation Attributes Scale (SIDAS) \[0 = Never, 10 = Always\]
Time frame: Change from baseline to 6 months
Suicide intent/risk
We will use the Suicidal Ideation Attributes Scale (SIDAS) \[0 = Never, 10 = Always\]
Time frame: Change from baseline to 12 months
Depression
Patient Health Questionnaire (PHQ-9) \[0 -not at all to 3-nearly every day\]
Time frame: Change from baseline to 3 months
Depression
Patient Health Questionnaire (PHQ-9) \[0 -not at all to 3-nearly every day\]
Time frame: Change from baseline to 6 months
Depression
Patient Health Questionnaire (PHQ-9) \[0 -not at all to 3-nearly every day\]
Time frame: Change from baseline to 12 months
Anxiety
Generalized Anxiety Disorder scale (GAD-7) \[0 -not at all to 3-nearly every day\]
Time frame: Change from baseline to 3 months
Anxiety
Generalized Anxiety Disorder scale (GAD-7) \[0 -not at all to 3-nearly every day\]
Time frame: Change from baseline to 6 months
Anxiety
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Generalized Anxiety Disorder scale (GAD-7) \[0 -not at all to 3-nearly every day\]
Time frame: Change from baseline to 12 months
Frequency of alcohol use
Number of days used in the past 30 days. \[ 0 to 30\]
Time frame: Change from baseline to 3 months
Frequency of alcohol use
Number of days used in the past 30 days \[ 0 to 30\]
Time frame: Change from baseline to 6 months
Frequency of alcohol use
Number of days used in the past 30 days \[ 0 to 30\]
Time frame: Change from baseline to 12 months
Alcohol use consequences
Number of times in the past 3 months youth experience 4 different alcohol consequences \[0 = Never to 6 = 20 or more times\]
Time frame: Change from baseline to 3 months
Alcohol use consequences
Number of times in the past 3 months youth experience 4 different alcohol consequences \[0 = Never to 6 = 20 or more times\]
Time frame: Change from baseline to 6 months
Alcohol use consequences
Number of times in the past 3 months youth experience 4 different alcohol consequences \[0 = Never to 6 = 20 or more times\]
Time frame: Change from baseline to 12 months
Sobriety self-efficacy
Three items ask how sure youth are about staying sober from alcohol from 1= def drink to 5 = def not drink
Time frame: Change from baseline to 3 months
Sobriety self-efficacy
Three items ask how sure youth are about staying sober from alcohol from 1= def drink to 5 = def not drink
Time frame: Change from baseline to 6 months
Sobriety self-efficacy
Three items ask how sure youth are about staying sober from alcohol from 1= def drink to 5 = def not drink
Time frame: Change from baseline to 12 months
Intentions to be sober from alcohol
Youth report on intentions to be sober in the next 6 months from 1 = def yes to 4 = def no
Time frame: Change from baseline to 3 months
Intentions to be sober from alcohol
Youth report on intentions to be sober in the next 6 months from 1 = def yes to 4 = def no
Time frame: Change from baseline to 6 months
Intentions to be sober from alcohol
Youth report on intentions to be sober in the next 6 months from 1 = def yes to 4 = def no
Time frame: Change from baseline to 12 months
Social network composition
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).
Time frame: Change from baseline to 3 months
Social network composition
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).
Time frame: Change from baseline to 6 months
Social network composition
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).
Time frame: Change from baseline to 12 months
Social network structure
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 frame: Change from baseline to 3 months
Social network structure
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 frame: Change from baseline to 6 months
Social network structure
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 frame: Change from baseline to 12 months
Time spent around peers who use alcohol
Participants will report on how much time is spent around peers who drink from 0 = never to 3 = often
Time frame: Change from baseline to 3 months
Time spent around peers who use alcohol
Participants will report on how much time is spent around peers who drink from 0 = never to 3 = often
Time frame: Change from baseline to 6 months
Time spent around peers who use alcohol
Participants will report on how much time is spent around peers who drink from 0 = never to 3 = often
Time frame: Change from baseline to 12 months
Awareness of connectedness
Youth report on feelings of connectedness to community, family and environment from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 3 months
Awareness of connectedness
Youth report on feelings of connectedness to community, family and environment from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 6 months
Awareness of connectedness
Youth report on feelings of connectedness to community, family and environment from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 12 months
Community protective factors
Youth Community Protective Factors Scale. Youth report on feelings about different protective factors from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 3 months
Community protective factors
Youth Community Protective Factors Scale Youth report on feelings about different community protective factors from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 6 months
Community protective factors
Youth Community Protective Factors Scale Youth report on feelings about different community protective factors from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 12 months
Individual protective factors
Youth report on feelings about different individual protective factors from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 3 months
Individual protective factors
Youth report on feelings about different individual protective factors from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 6 months
Individual protective factors
Youth report on feelings about different individual protective factors from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 12 months
Reasons for life
Brief Reasons for Life Scale from 1 not at all important to 5 very important
Time frame: Change from baseline to 3 months
Reasons for life
Brief Reasons for Life Scale from 1 not at all important to 5 very important
Time frame: Change from baseline to 6 months
Reasons for life
Brief Reasons for Life Scale from 1 not at all important to 5 very important
Time frame: Change from baseline to 12 months
Reflective processes
The Reflective Processes scale taps a culturally patterned type of awareness and youth report from from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 3 months
Reflective processes
The Reflective Processes scale taps a culturally patterned type of awareness and youth report from from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 6 months
Reflective processes
The Reflective Processes scale taps a culturally patterned type of awareness and youth report from from 1 = strongly agree to 5 strongly disagree
Time frame: Change from baseline to 12 months