Collaboratively Adapting Culturally-Respectful, Locally-Relevant Suicide Prevention for Newly Participating Alaska Native Communities

Because suicide is deeply connected to local, historical and relational contexts, effective suicide prevention strategies must balance maintaining fidelity of evidence-based practices and adapting for the unique needs of diverse communities. Promoting Community Conversations About Research to End Suicide (PC CARES) builds the capacity of local people in close-knit rural Alaska Native communities to take preventative actions based on existing relationships, roles, and priorities. In a series of learning circles, community members learn about multilevel evidence-based suicide prevention practices, apply the information to personal and cultural contexts, and develop plans for taking action—on their own terms—in their lives. Here, we describe the participatory process used to adapt PC CARES from one region of Alaska to another, aiming to maximize transferability, practicality and relevance in our partner communities. With the shared goal of promoting self-determined, evidence-informed, community-based suicide prevention, the adaptation process included negotiating between comprehensiveness and understandability; subject appeal and utility; predictability and customizability, through consensus-building with researchers and community members. Lessons learned can be helpful to others working to navigate community-specific priorities and evidence-based approaches to develop interventions that can work across many different communities.