Culturally Adapting Caring Contacts for Suicide Prevention in Four Alaska Native and American Indian Communities

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.

Keywords:

• Alaska Native
• American Indian
• cultural adaptation
• focus groups
• qualitative
• suicide prevention

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.