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N/A N=284 Randomized Prevention

Southwest Hub for American Indian Youth Suicide Prevention Research

Suicide · Surveillance · Mental Health · Substance Use · Depressive Symptoms

Enrolled (actual)
284
Serious AEs
17.6%
Results posted
Jan 2026
Primary outcome: Primary: Suicide Ideation Questionnaire (SIQ) — 10.2; 10; 10.1; 10.1 Z-score

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
New Hope (NH) (Behavioral); Elders Resilience (ER) (Behavioral); Case Management (CM) (Other)
Age
Pediatric, Adult · 16+ yrs
Sex
All
Sponsor
Johns Hopkins Bloomberg School of Public Health
Primary completion
Nov 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
Suicide Ideation Questionnaire (SIQ)
10.2; 10; 10.1; 10.1; 9.9; 9.8
PRIMARY
The Resiliency Scales
31.7; 30.8; 33.3; 31.7; 43.9; 25.6
SECONDARY
Centers for Epidemiologic Studies of Depression (CESDR-10)
15; 15; 14.5; 11; 8; 12
SECONDARY
The Children's Hope Scale (CHS)
14.4; 14.2; 15.2; 14.6; 17.6; 13.5
SECONDARY
Multicultural Mastery Scale
30.7; 29.9; 30.7; 30.9; 34.2; 29
SECONDARY
Rosenberg Self Esteem Scale
17.5; 17.7; 17.5; 16.5; 15.8; 16.5
SECONDARY
Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) Risk Score
19; 15; 18; 12; 5; 21

Summary

1. To use a SMART design to evaluate which of four sequences of New Hope (NH), Elders Resilience (ER) and Case Management (CM) have the greater effects on immediate and longer-term suicidal ideation (primary outcome) and resilience (secondary outcome) among American Indian (AI) adolescents ages 10-29 identified at risk for suicide. Hypotheses: i. New Hope vs. CM alone will significantly reduce participant suicidal ideation. ii. Elders Resilience vs. CM alone will significantly improve participant resilience. iii. New Hope followed by Elders Resilience will have the strongest effects on suicidal ideation and resilience. iv. CM alone will have the weakest effects of all combinations. Secondary Aims: 2. To examine mediators and moderators of treatment effectiveness and sequencing in order to determine which types and sequence of interventions is best suited for which youth. 3. To assess the acceptability, feasibility and capacity for sustainability of the Hub's key intervention components (Surveillance/Case Management, New Hope and Elders' Resilience) from the perspective of multiple stakeholders as they are implemented across different tribes.

Eligibility Criteria

Aim 1

Inclusion Criteria

  • Native American youth ages 10 to 29 years old.
  • Reside on or near the Fort Apache Indian Reservation.
  • Parent/guardian consent for youth under 18 years old.
  • Suicide ideation, binge substance use with recent (i.e. within the last 3 months) suicide ideation, or suicide attempt in the past 30 days as identified and verified by the surveillance system or release from inpatient care related to suicide ideation or attempt within past 30 days.

Terms and Definitions: Definitions for reportable behaviors are modeled on the Columbia Classification Algorithm for Suicide Assessment (C- CASA).[11] Suicide attempt: intentional self-injury with intent to die. (Aborted and interrupted suicide attempts are included as part of this category). Suicidal ideation: thoughts to take one's own life with or without preparatory action. Binge substance use with recent ideation, defined by Apache stakeholders, as consuming substances with the intention of modifying consciousness and resulting in being found unresponsive or requiring ED treatment and answering positively to a 1-item screening question on the assessment indicating suicide ideation within the past three months.

Exclusion Criteria

  • Factors identified at baseline that preclude full participation, including: unstable and severe medical, psychiatric or drug use problem that necessitates inpatient treatment; acute suicidal or homicidal ideation requiring immediate intervention; recent, severe stressful life events such as physical or sexual abuse, or violent crime victimization that requires specific and high intensity interventions or out of home placement. Participants must speak English and not be severely visually impaired. Foster children will not be included. Ambiguous cases will be reviewed by one of the co-PIs before being deemed eligible for recruitment.

Aim 3

Inclusion Criteria

  • Youth over the age of 16 or adults over the age of 18.
  • A person with an interest or concern related to youth suicide among AI populations.

Exclusion Criteria

  • Factors identified at baseline that preclude full participation including: being under the influence of a substance; active psychosis or mania; any other condition that makes an individual lack capacity to give consent. Foster children will not be included. Participants must speak English and not be severely visually impaired. Ambiguous cases will be reviewed by one of the co-PIs before being deemed eligible for recruitment.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03543865). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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