posted on 2022-01-20, 09:19authored byRuth Striegel Weissman,, Brandon G. Scott, Kelley Edwards, Jennifer S. Rose, Matthew Kuntz, Holly C. Wilcox
Abstract: Rural youth suicide represents a major source of mental health inequity
in the United States (US). School-based suicide prevention programs may
provide an effective avenue to address this mental health crisis among
rural youth. This study’s primary goal is to demonstrate the feasibility
and acceptability of a novel implementation approach (utilizing
teachers from a neighboring school) for delivering the Youth Aware of
Mental Health (YAM) program, an evidence-based, universal youth suicide
prevention curriculum, to high school students in rural Montana. We will
recruit approximately 1300 9th grade student in four Montana schools.
Using a non-inferiority design, we will randomize classrooms in each
school to be instructed by a teacher from another school (YAM-TE;
experimental) or a traditional external instructor (YAM-EXT; control).
We will assess program fidelity of both YAM training and implementation
via independent observer and instructor-reporter ratings. Youth will
complete measures of acceptability at post-YAM and outcome measures at
pre-YAM, post-YAM, and 12-month follow-up. Standard and mixed linear and
logistic regression models will be used to test the main hypothesis
that the YAM-TE does not differ from YAM-EXT regarding fidelity
(teachers) and acceptability (teachers and youth). Exploratory analyses
will test moderation of the intervention effect (e.g., sex, poverty) and
the mediating effect of mental health literacy, belongingness, and
perceived burdensomeness on the intervention effect. Results of this
pilot study will inform the development of subsequent, fully powered
noninferiority trials. Our long-term goal is to scale YAM-TE for
implementation across rural US communities or, if culturally
appropriate, more globally.
History
Preregistration details
This study protocol was preregistered with Discover Psychology