The objective of this proposal is to develop and pilot a systems-level strategy in pediatric primary care to enhance identification and management of suicidal ideation and behavior in Latinx youth, particularly those in immigrant families with parents who have limited English proficiency (LEP). The investigators will focus on the use of trained community health workers (CHWs) to increase clinic capacity and quality of suicide risk screening and early intervention, with a focus on safety planning, parent psychoeducation and care coordination. Specific aims are 1: To develop site-specific implementation protocols for the integration of CHWs into SIB screening and safety planning for Latinx youth and the youths families; 2: To pilot the implementation of the program in a six-month open trial in four pediatric primary care practices representing a range of usual practice settings; and 3: To engage a stakeholder network to explore barriers and facilitators, including costs and billing strategies, to implementation of this approach across a broad range of pediatric primary care settings. Parents/guardians of youth who have been referred to and agree to participate in the intervention by the child's primary care provider will participate in a 2-month program consisting of 6-8 phone sessions with a community health worker focusing on safety planning, information/education, program solving and self-care. Research participants will be asked to complete a survey via phone at the beginning of the program and another at the end of the program. The participants may also be asked to participate in an additional interview about the study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
76
Partnering with Parents of Adolescent Latinos on Mental Health Assistance
BMS at Yard 56
Baltimore, Maryland, United States
Percent of Participants Screened
Percent of patients 10-18 years old screened for depression and suicidal ideation and behavior at clinic level
Time frame: Monthly for 9 months
Feasibility as assessed by percent of sessions completed
Percent of eligible patients receiving a CHW session
Time frame: Monthly for 9 months
Quality as assessed by percent of CHW visits
Percent of CHW visits that include delivery of one or more intervention components
Time frame: Monthly for 9 months
Engagement as assessed by number of follow-up visits
number of follow-up mental health visits with PCP or specialty provider among youth identified as having suicidal ideation or behavior.
Time frame: Monthly for 9 months
Family Functioning as assessed by the SCORE-15 Index of Family Functioning and Change (SCORE-15)
SCORE-15 Index of Family Functioning and Change: Score range 5-15, higher total means worse functioning.
Time frame: Baseline and 3 months
Parent Self Efficacy as assessed by Brief Parenting Self Efficacy Scale (BPSES) Questionnaire
Brief Parenting Self Efficacy Scale (BPSES) Questionnaire: Total score ranges from 5 to 25, higher scores indicate higher levels of parental self-efficacy.
Time frame: Baseline and 3 months
Depression as assessed by the Patient Health Questionnaire - Adolescent (PHQ-A)
Patient Health Questionnaire - Adolescent (PHQ-A): Each item on the PHQ-A is scored as follows: Not at all = 0 Several Days = 1 More than half the days = 2 Nearly every day = 3. A weighted score of 5 or more means a positive screen for depressive symptoms. A weighted score of 0-4 means a negative screen for depressive symptoms.
Time frame: Baseline and 3 months
Suicidal Ideation and Behavior as assessed by the Ask Suicide-Screening Questionnaire (ASQ)
Ask Suicide-Screening Questionnaire (ASQ): 4 Yes or No Questions. "Yes" to questions 1 through 4, or refuses to answer is considered a positive screen. "Yes" to question 5 = acute positive screen (imminent risk identified); "No" to question 5 = non-acute positive screen.
Time frame: Baseline and 3 months
Parental Self-Efficacy to Support Teens During a Suicidal Crisis survey
9 items. Answer choices ranged from 0 (not at all confident) to 10 (completely confident), with an anchor of 5 (somewhat confident); score range 0-90; higher score higher confidence.
Time frame: Baseline and 3 months
Parent expectations of adolescents' risk survey
3 items. Answer choices ranged from 0 (not at all confident) to 10 (completely confident), with an anchor of 5 (somewhat confident). Score range 0-30; higher score higher confidence.
Time frame: Baseline and 3 months
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