Improving Firearm Storage in Alaska Native Villages
SuicideSuicide2 moreRates of suicide among young Alaska Native males are over ten-fold higher than among a similar age cohort in the rest of the United States. A high proportion of these deaths are associated with firearms. Firearms are an important part of the subsistence lifestyle of this population, however restriction of access to guns by youth may be a promising strategy to reduce the risk of suicides in this population. Previous research conducted in the first phase of this project has demonstrated that about 75% of homes in rural southwest Alaskan villages have guns, and only about 15% of these guns are locked; 6% are loaded. The aims of this specific phase of the study to execute a randomized trial of an intervention to improve firearm storage practices among residents of selected villages. Our hypothesis is that households receiving training and equipment to store firearms in gun lockers will be more likely to store their guns locked at 12 months, compared to households not receiving the intervention.
RCT of Post-Suicide Attempt Case Management (ACTION-J)
Suicide AttemptThis study will determine the effectiveness of continuous follow-up care by case manager in preventing further suicide attempts
Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT)
DepressionSuicide1 moreThe purpose of this study was to determine the effect of a primary care intervention on reducing suicidal ideation and depression in older patients.
Randomized Trial to Improve Safe Firearm Storage
Firearm InjuryPediatric Emergency Medicine2 moreThe goal of this clinical trial is to test the effect of providing gun locks to caregivers of children presenting to the emergency department for mental health concerns. The main question it aims to answer is: • Does the provision of gun locks result in higher rates of securement of all household firearms? Participants will be randomized to receive either lethal means counseling (including summary handout) by study team with the provision of 2 cable-style gun locks or lethal means counseling by study team alone (without provision of gun locks). Researchers will compare the lethal means counseling with 2 gun locks group to the lethal means counseling alone group to see if it affects self-reported securement of all household firearms, 4 weeks post emergency department encounter.
Online Suicide Prevention Campaign Aimed at Men
Help-Seeking BehaviorSuicideThis study aims to examine whether the online suicide prevention campaign for men could increase openness about emotions and help-seeking behavior, and decrease hopelessness and adherence to traditional gender norms concerning self-reliance among men. The effectiveness of the campaign will be evaluated in adult men using a pre-post questionnaire study design.
Clinical Decision Support to Prevent Suicide
SuicideAttempted1 moreSuicide kills 132 Americans every day. The first step of suicide prevention is risk identification and prognostication. Researchers like this study team have developed and validated predictive models that use routinely collected Electronic Health Record (EHR) data like past diagnoses and medications to predict future suicide attempt risk. The study team's model based in machine learning is known as the Vanderbilt Suicide Attempt and Ideation Likelihood (VSAIL). VSAIL has been validated prospectively and externally to predict suicide attempt risk with a number needed to screen (NNS) of 271 for suicide attempt and 23 for suicidal ideation. NNS is the number of people who need to receive a test result to prevent one outcome - lower NNS is better. This study will evaluate the effectiveness of a Clinical Decision Support System called Vanderbilt Safecourse using VSAIL to prompt a novel Best Practice Advisory (BPA) to prompt face-to-face screening with a validated suicide screening instrument like the Columbia Suicide Severity Rating Scale (CSSRS).
Firearm Storage Device Distribution to Families of Children With Mental Health Complaints
Mental Health DisordersSuicide or Selfinflicted Injury by Firearms and ExplosivesThis study aims to describe the baseline rate of safe firearm storage device use in the homes of pediatric patients with mental health complaints treated in the Emergency Department (ED) and/or inpatient psychiatric unit of an urban tertiary pediatric hospital. Follow-up data will be collected to ascertain any change(s) in the rate of safe firearm storage device use after patients have been treated for a mental health complaint, which includes standardized recommendations for safe firearm storage practices. This study also involves an intervention to distribute safe firearm storage devices to families of pediatric mental health patients during their hospital visit, and assesses whether safe storage device distribution impacts reported future rate of firearm safety device use.
Suicide Prevention Algorithm in the French Overseas Territories
Suicide AttemptIn France, suicide behaviours are a major public health concern that triggered the creation in 2013 of a National Observatory of Suicide. In continental France, the "Algos" protocol was found to be effective for the prevention of suicide attempts reiterations. This protocol is based on a procedure that keeps telephone and postal contacts with the suicide attempter and allows, via an algorithm, to assess the risk of suicide attempt recurrence, in order to intervene if necessary. Nevertheless, Algos does not involve primary care health practitioners, who could add a substantial additional efficacy, especially if they intervene downstream and in supplement to Algos. In addition, this kind of protocol has never been evaluated in the French overseas territories.
Randomized Trial of Stepped Care for Suicide Prevention in Teens and Young Adults
Suicidal BehaviorSelf-Harm3 moreThis randomized controlled trial will evaluate two approaches to achieving the aspirational goal of Zero Suicide within a health system: 1) Zero Suicide Best Practices initiated through a zero suicide quality improvement initiative within a health system; and 2) Zero Suicide Best Practices plus an innovative stepped care for suicide prevention intervention for adolescents and young adults that matches treatment intensity with risk levels for suicide/self-harm. ..
Preventing Addiction Related Suicide (PARS)
SuicideSubstance-Related DisordersThe goal of this study is to evaluate the effectiveness and utility of the investigator's National Institute on Drug Abuse (NIDA) R21 developed "Preventing Addiction Related Suicide" (PARS) program by utilizing a novel stepped wedge design to evaluate PARS as a selected prevention program to increase help-seeking by clients in community addiction treatment.