Taking a public health approach to suicide prevention is vital to addressing the systemic factors that contribute to the high rates of suicide among AIAN youth. This requires mobilizing resources and strategies across the spectrum of prevention. In this paper, we highlight how developing collaborative relationships for suicide prevention (Communities of Practice, or ‘CoP’) and self-efficacy for wellness promotion and suicide prevention can advance multi-sector community actions for upstream prevention.
Linking Communities of Practice and Self-Efficacy to Suicide Prevention
We examine and describe the connections between community members’ perceived self-efficacy, community of practice, and actions taken for prevention, considering the different roles different people play in their communities. This involved analyzing survey data from 398 participants over the age of 15 from five remote AN communities, collected through our community-based participatory study on PC CARES (Promoting Community Conversations About Research to End Suicide).
We looked at how participants’ self-perceptions about their ability to promote wellness (wellness self-efficacy) and prevent suicide (prevention self-effiacy) affect their actions taken for wellness and prevention. We also examined how having a community of practice influences the types of promotion and prevention actions taken. Here are some findings in this article:
Collaborative Capacity Drives “Working Together” Behaviors
Participants who felt more well-equipped to support wellness (wellness self-efficacy) and who had others in the community they could work with for wellness and prevention (CoP) reported taking more collaborative actions to prevent suicide and promote health (“working together” behaviors).
Confidence Sparks Supportive Actions
Participants with higher wellness self-efficacy and prevention self-efficacy took actions to offer support to someone going through a hard time (“interpersonal support” behaviors).
Strength in Community for Postvention
Having prevention self-efficacy and a community of practice were linked to more actions taken to create healthy community spaces to grieve and process after a suicide death (“postvention” behaviors).
Prevention Self-Efficacy and Lethal Means Reduction
Among participants with high prevention self-efficacy, more actions related to restricting access to lethal means, like medications and firearms, were reported (“lethal means” behaviors).
Building on Strengths for Upstream Impact
These results expand the field of suicide prevention in key ways, underscoring the importance of leveraging family, community, and cultural strengths in preventing suicide before a crisis.
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Wexler, L., White, L., Ginn, J., Schmidt, T., Rataj, S., Wells, C. C., Schultz, K., Kapoulea, E. A., McEachern, D., Habecker, P., & Laws, H. (2025). Developing self-efficacy and 'communities of practice' between community and institutional partners to prevent suicide and increase mental health in under-resourced communities: expanding the research constructs for upstream prevention. BMC public health, 25(1), 1323. https://doi.org/10.1186/s12889-025-22465-1