Suicide interventions for American Indian and Alaska Native populations: A systematic review of outcomes

Pham, Tony V; Fetter, Anna Kawennison; Wiglesworth, Andrea; Rey, LittleDove F.; Chicken, Micah L. Prairie; Azarani, Michael; Riegelman, Amy; Gone, Joseph P.

doi:10.1016/j.ssmmh.2021.100029

Cited by 13 publications

(9 citation statements)

References 62 publications

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“…This work is grounded in cultural processes and, since its creation, has been piloted as a prevention program for Yup'ik youth (Allen et al, 2018). This approach of leveraging protective factors in intervention programming has also been used by others (e.g., Barnett et al, 2020;Cwik et al, 2019;Wexler et al, 2017), demonstrating the common understanding of protective factors as being a target for intervention among researchers (e.g., Pham et al, 2021).…”

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confidence: 99%

Attempted suicide in American Indian and Alaska Native populations: A systematic review of research on protective factors.

Wiglesworth¹,

Rey²,

Fetter³

et al. 2022

Clinical Psychology: Science and Practice

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American Indian and Alaska Native (AIAN) populations contend with disproportionately high rates of suicide. The study of protective factors is essential for highlighting resilience and formulating potential interventions for suicide. We systematically review factors that are posited to protect against suicide attempts for AIAN peoples. Seventeen (12 journal articles, five theses/dissertations) articles met inclusion criteria. Results indicate that protective factors are typically situated at one of four levels of analysis: individual (e.g., self-esteem), family (e.g., parent caring), community (e.g., positive adult relationships), and cultural (e.g., cultural spiritual orientation). Notably, there were trends in protective factors across age, sex, and geographic region. Based on these findings, we propose recommendations for moving the field forward in future identification of protective factors as a means of AIAN suicide prevention.

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confidence: 99%

Attempted suicide in American Indian and Alaska Native populations: A systematic review of research on protective factors.

Wiglesworth¹,

Rey²,

Fetter³

et al. 2022

Clinical Psychology: Science and Practice

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“…While the research on acculturation and suicide risk is mixed, the role of acculturation in the relationship between cultural or racial affiliation and suicide risk is important (Castle et al, 2011; Smokowski et al, 2009; Walker, 2007). As such, promoting culture is a central tenet of many extant NA suicide prevention programs (Pham et al, 2021). These heterogeneities within biracial populations were not able to be meaningfully delineated in this study, which may have contributed to the similar patterns observed here between NA, BL‐NA, and NA‐WH.…”

Section: Discussionmentioning

confidence: 99%

“…Important efforts have been made in evidencing the disproportionately high rates of SI, SA, and death by suicide (Bai & Specker, 2019; Mackin et al, 2012; Qiao & Bell, 2017), identifying risk and protective factors, and developing culturally grounded intervention strategies for NA (Alcántara & Gone, 2007; Allen et al, 2018; Pham et al, 2021). However, a recent systematic review of the past decade of NA suicide literature points to the lack of data regarding multiracial NA (Rey et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Understanding suicide risk for youth who are both Black and Native American: The role of intersectionality and multiple marginalization

Wiglesworth

Clement

Wingate

et al. 2022

Suicide & Life Threat Behav

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Introduction: Native American and multiracial youth experience elevated risk for suicide ideation (SI) and suicide attempts (SA); however, intersectional identities are often unexamined in suicide research. Method:We examined the prevalence of SI and SA, and the impact of intersectional identities (sex, sexual minority identity, and economic insecurity) on these rates, in 496 biracial Black-Native American, 2,804 Native American, 14,220 Black, 5,569 biracial Native American-White, 4,076 biracial Black-White, and 118,816 White youth who participated in the Minnesota Student Survey.Results: Black-Native American youth reports of SI and SA resembled other Native American youth and were significantly higher than those reported by Black, White, and Black-White (SA only) youth. While sexual minority youth reported higher rates of SI and SA than heterosexual youth, this difference between sexual minority and heterosexual Black-Native American youth was smaller as compared to their peers. Conclusion:Though they largely resemble their mono/biracial Native American peers, Black-Native American youth show some distinct patterns of SA when accounting for their intersectional identities. Despite presumed similarities in systemic risk factors, Black and Black-Native American youth differ considerably in reported suicidality. The experiences of Black-Native American teens warrant further examination. K E Y W O R D Sadolescence, biracial youth, Black populations, intersectionality, Native American populations, suicide 1 Throughout this manuscript, authors have used terms such as "Native American," "Latinx," "Hispanic," "Minority," "Minoritized," and "Marginalized." We recognize that individuals within these groups are not monolithic and may not identify with these terms. We acknowledge that discussions surrounding racial and ethnic identity are fluid and evolving.

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“…Further, a recent systematic review (Pham et al, 2021) noted only two AIAN suicide prevention programs were evaluated by more than one outcome study, and only Qungasvik consistently produced positive outcomes. In addition to developing a culturally commensurate intervention, the Qungasvik team made a methodologically based decision to not pursue designs that risk underpowered testing, and to instead use methods more appropriate to small populations that were acceptable to communities.…”

Section: Discussionmentioning

confidence: 99%

Culturally grounded strategies for suicide and alcohol risk prevention delivered by rural Alaska Native communities: A dynamic wait‐listed design evaluation of the Qungasvik intervention

Allen

Charles

Fok

et al. 2022

American J of Comm Psychol

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We examined the effectiveness of the Qungasvik (Tools for Life) intervention in enhancing protective factors as a universal suicide and alcohol prevention strategy for young people ages 12−18 living in highly affected rural Alaska Native communities. Four communities were assigned to immediate intervention or to a dynamic wait list. Outcomes were analyzed for 239 young people at four time points over two years of community intervention. Outcomes assessed two ultimate variable protective factors buffering suicide and alcohol risk, and three intermediate variable protective factors at the individual, family, and community level. Dose dependent intervention effects were associated with growth in ultimate but not intermediate variables. This evaluation of the Qungasvik intervention provides support for the effectiveness of its Indigenous strategies for suicide and alcohol misuse prevention in this rural Alaska Native setting. Though findings did not provide support for a theory of change where growth in ultimate variables is occasioned through effects on intermediate variables, research designs focused on young people who enter intervention at lower levels of preexisting protection hold promise for better understanding of intervention change processes. The Qungasvik intervention is responsive to an acute public health need for effective rural Alaska Native suicide and alcohol risk prevention strategies.

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Suicide interventions for American Indian and Alaska Native populations: A systematic review of outcomes

Cited by 13 publications

References 62 publications

Attempted suicide in American Indian and Alaska Native populations: A systematic review of research on protective factors.

Attempted suicide in American Indian and Alaska Native populations: A systematic review of research on protective factors.

Understanding suicide risk for youth who are both Black and Native American: The role of intersectionality and multiple marginalization

Culturally grounded strategies for suicide and alcohol risk prevention delivered by rural Alaska Native communities: A dynamic wait‐listed design evaluation of the Qungasvik intervention

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