Making deep-structure adaptations: A community-engaged qualitative study for culturally adapting suicide prevention interventions for Black youth.

Objectives: This study responds to the suicide crisis among Black youth populations by tailoring suicide interventions to meet their specific cultural needs. We obtained insight from community stakeholders about culturally adapting suicide prevention interventions for Black youth, using the Linking Individuals Needing Care intervention as an example. Method: Using a culturally adaptive qualitative design Process, we conducted a series of community-engaged focus groups over 6 months with four distinct participant groups of diverse genders, including Black youth ages 13-19, caregivers, community members, and providers. Our participants (N = 58) provided feedback on intervention adaptations in a reiterative process aligned with the Ecological Validity Model. Results: We found recommendations for deep-structure-level cultural adaptations versus surface-structure-level adaptations. Themes included (1) Using wellness and collective focused language, (2) Prioritizing mutual trust, (3) Disrupting and reframing cultural myths, (4) Integrating Black-focused content to validate identities, (5) Affirming Black youth and family protective factors and stressors, (6) Developing relevant and attainable youth and family goals, (7) Infusing culture into crisis planning, and (8) Creating a Black-centered community of care. Findings illuminate the need for a focus on racial socialization and validating the strengths of Black youth versus their struggles, which is meaningful for suicide prevention efforts. Conclusions: For suicide prevention intervention design with Black youth, community feedback needs to be prioritized, deep-structure level adaptations included, and racial socialization content embedded. (PsycInfo Database Record (c) 2025 APA, all rights reserved).