Abstract
Aim
Despite substantial tribal, state, and federal effort, American Indian and Alaska Native (AI/AN) suicide rates have changed little in the last 30 years, prompting attention to new and innovative approaches to this persistent health disparity. Suicide prevention interventions with demonstrated success in other populations may be useful in AI/AN communities. Caring Contacts is a suicide prevention intervention that has been adapted and shown to reduce suicide ideation, attempts, and deaths in other populations.
Methods
We used a community-based participatory research approach to gather qualitative data from community members, healthcare providers, and leaders in four AI/AN communities. These data were analyzed thematically and used to adapt Caring Contacts for use in a subsequent clinical trial with AI/AN people at high risk for suicide.
Results
A total of 189 community members and other health system stakeholders in four tribal communities participated in focus groups and interviews. Caring Contacts was perceived in all communities to be acceptable. Feedback for intervention adaptations focused on the themes of trial eligibility criteria; instruments; message frequency, timing, and content; and cultural considerations.
Conclusion
Overall, AI/AN study participants in four diverse AI/AN communities endorsed the use of Caring Contacts for suicide prevention in their communities. Intervention adaptations for use in these communities centered primarily on message frequency and timing as well as expanding access to Caring Contacts. The results of this study may be applicable to other populations that experience suicide-related health disparities.
ACKNOWLEDGEMENTS
Thank you to the partnering communities and participants who made this work possible.
Additional information
Notes on contributors
Kelley J. Jansen
Kelley J. Jansen, Research Department, Southcentral Foundation, Anchorage, AK, USA.
Jennifer L. Shaw
Jennifer L. Shaw, Research Department, Southcentral Foundation, Anchorage, AK, USA.
Katherine Anne Comtois
Katherine Anne Comtois, Center for Suicide Prevention and Recovery, University of Washington, Seattle, WA, USA.
Emma Elliott-Groves
Emma Elliott-Groves, Center for Suicide Prevention and Recovery, University of Washington, Seattle, WA, USA.
Trevor Slaney
Trevor Slaney, Washington State University Partnerships for Native Health, I-REACH, Seattle, WA, USA.
Jaedon P. Avey
Jaedon P. Avey, Research Department, Southcentral Foundation, Anchorage, AK, USA.
Lonnie Nelson
Lonnie Nelson, Washington State University Partnerships for Native Health, I-REACH, Seattle, WA, USA.