Feasibility and Acceptability of a Brief Intervention for Youth Suicidal Thoughts and Behaviors Among Pediatric Primary Care Providers.

Caitlin M Pinciotti, Erica Buckland, Taryn L Mayes, John L Cooley, Sean M Mitchell, Lucas Zullo, Jennifer L Hughes, Puja G Patel, Colleen Neal, Melissa DeFilippis, Taiwo T Babatope, Carmen Cruz, Madhukar H Trivedi, Eric A Storch, Wayne K Goodman, Laurel L Williams, Joan R Asarnow
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Abstract

Background: Suicide is a leading cause of death among youth, and rates continue to increase across the United States. Pediatric primary care providers (PCPs) are uniquely positioned to identify acute periods of increased suicidal ideation and provide timely intervention.

Objective: The present study assessed the feasibility and acceptability of training and implementation of a primary care-adapted version of Safe Alternatives for Teens and Youth-Acute (SAFETY-A), a brief, strengths-based, cognitive-behaviorally oriented, family intervention for suicidal thoughts and behaviors in youth, among pediatric PCPs.

Method: This multisite pilot study involved collaboration between eight Texas-based academic institutions who assisted with the recruitment and training of 68 PCPs. PCPs attended five SAFETY-A training sessions and completed self-report surveys for 6 months post-training.

Results: Prior to SAFETY-A training, PCPs indicated a significant training gap, with 83% indicating that they had not received sufficient prior training in suicide risk assessment and risk reduction/intervention. PCPs found SAFETY-A training acceptable, reporting significant improvements in knowledge, skills, and confidence. PCPs also found SAFETY-A implementation feasible, using the intervention a total of 288 times over the course of 6 months (M uses per PCP = 6.9). However, PCPs found the SAFETY-A training schedule less feasible, with many PCPs unable to attend all five training sessions.

Conclusions: Findings suggest that a tiered training structure allowing for more flexibility in training commitment might be more feasible for busy PCPs seeking training in SAFETY-A. Ongoing efforts to feasibly scale-up SAFETY-A training efforts across Texas incorporate these findings with the goal of making SAFETY-A training available to all PCPs across the state.

儿科初级保健提供者对青少年自杀念头和行为的简短干预的可行性和可接受性。
背景:自杀是导致青少年死亡的主要原因,在美国自杀率持续上升。儿科初级保健提供者(pcp)具有独特的定位,以识别急性时期增加自杀意念,并提供及时的干预。目的:本研究评估了初级保健版青少年和青少年急性期安全替代方案(SAFETY-A)的培训和实施的可行性和可接受性,这是一种简短的、基于优势的、以认知行为为导向的、针对青少年自杀念头和行为的家庭干预。方法:这项多地点的试点研究涉及德克萨斯州八所学术机构的合作,他们协助招募和培训了68名pcp。pcp参加了5次SAFETY-A培训课程,并在培训后6个月内完成了自我报告调查。结果:在SAFETY-A培训之前,pcp显示出明显的培训差距,83%的pcp表示他们没有接受过足够的自杀风险评估和风险降低/干预方面的培训。pcp发现SAFETY-A培训是可以接受的,报告了在知识、技能和信心方面的显著提高。PCP也发现SAFETY-A的实施是可行的,在6个月内总共使用了288次干预措施(每个PCP使用次数= 6.9次)。然而,pcp发现SAFETY-A培训计划不太可行,许多pcp无法参加所有五个培训课程。结论:研究结果表明,对于在SAFETY-A中寻求培训的忙碌的pcp来说,允许更灵活的培训承诺的分层培训结构可能更可行。正在进行的在德克萨斯州范围内切实扩大SAFETY-A培训工作的努力将这些发现与使全州所有pdp都能获得SAFETY-A培训的目标结合起来。
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