Details about research participation

Overview

This intervention study will measure the outcomes of the PC CARES (Promoting Community Conversations about Research to End Suicide) curriculum implemented in rural Alaskan villages and remotely during COVID-19 pandemic years (2020-2022). We will compare pre-post data from intervention participants to non-participants, and will analyze social networks related to suicide prevention behavior in each village. 

Specific Aims:

1. Document the feasibility, satisfaction and perceived benefits of PC CARES At Home. 

2. Track the effect of PC CARES At School on participants’ knowledge, attitudes and behavior, and identify key factors influencing these outcomes over time. 

3. Document the community-level impact of PC CARES At School by describing and tracking the number and type of interactions aimed at preventing youth suicide and promoting wellness in participating schools. 

A description of this clinical trial is available on www.ClinicalTrials.gov, as required by the National Institutes of Health (NIH). This website will NOT include information that could identify participants.

View the description here: https://clinicaltrials.gov/ct2/show/NCT03661255

Project background

To measure baseline levels of suicide prevention activity, knowledge, and attitudes, we collected pre-intervention data in 5 villages. Within the villages, we focused on individuals working at or in formal institutions (e.g., tribe, city, clinic, school) and youth ages 15-24. When the intervention was halted to follow health authority guidelines for the COVID pandemic, PC CARES pivoted to online, remote synchronous delivery (live Zoom sessions) with school and clinic staff in any of the Bering Strait region and Northwest Arctic region communities (27 villages total). Schools have key infrastructure for the virtual intervention like wireless Internet, and school staff are well-positioned to make impacts on youth wellness. The intervention was further adapted by adding an additional session and resources regarding school-specific suicide prevention strategies. From this adapted model, the baseline survey was distributed via email within organizations instead of collected in person.

To recruit participants for the intervention, we offered online, all-staff trainings for Bering Strait School District, Northwest Arctic School District, Norton Sound Health Corporation, and Maniilaq Behavioral Health staff on what they and their organization can do to prevent youth suicide. Afterward, interested staff and community members were invited to participate in a Training of Facilitators and/or virtual learning circles hosted by PC CARES trainers. School staff who were at least 18 years old, and who participated in any level of training will have the option to participate in 3 online surveys (emailed to them) to assess their changes in Attitudes, Skills, Behavior, Knowledge and Community of Practice related to suicide prevention: 1) before any trainings are offered, 2) soon after the all-staff training, and 3) at the end of the school year. Staff are also welcome to participate in PC CARES without being research participants.

Participants in the all-staff training filled out a registration form to indicate their interest in attending virtual PC CARES. The registration form included a description of the research and consent form. If they gave their informed consent, participants were brought to the Virtual PC CARES Baseline Survey, which mirrors the Steps Toward Prevention Survey, with a few added questions pertaining to the school context.

Supplemental implementation study

As a supplement to the original grant and the virtual adaptation, we initiated a small implementation-focused study. In this additional project, a cohort of students in the Rural Human Services Certificate Program at University of Alaska-Fairbanks, Kuskokwim campus will fulfill their practicum requirement by facilitating PC CARES Learning Circles in their home communities in rural remote western Alaska. Students who consent to participate in the study will complete 3 surveys (Pre-Training, Post-Training, and 6-Month Follow Up). In addition, we asked for consent to take field notes during the facilitator training and during the monthly facilitator support calls. These field notes focus on what kinds of questions are raised by trainees, what challenges and success they have as facilitators, and other information related to the experience of being a facilitator.

View the implementation study consent forms here:

Field notes consent

Facilitator survey consent

Baseline Steps toward Prevention Survey

To understand the levels of knowledge and frequency of prevention-related activities in communities before anyone has experienced PC CARES, we recruit widely for the Baseline Steps toward Prevention (StP) Survey, focusing on individuals working at or in formal institutions (e.g., tribe, city, clinic, school) and youth ages 15-24. The Baseline StP Survey asks for demographic information like age, race, and sex, and looks at knowledge about reducing suicide, skills in making positive community changes, attitudes toward suicide prevention, and behavior related to suicide prevention. Questions about behavior included follow up questions asking with whom they've done the behavior (chosen from a list) and 'how often' they took that action.

View the Baseline StP Survey consent forms here:

Parental consent

Youth (under 18) assent

Adult (18+) consent

Post-Learning circle surveys

PC CARES Learning Circles are open to all residents aged 15+, and are hosted in public spaces in each village (e.g. tribal building, school, city building). Participation is limited to older teens because of the level of maturity needed to understand and make use of the information discussed at PC CARES.

After each Learning Circle, all participants are invited to complete a survey that includes questions about their skills, knowledge and attitudes toward taking preventive action (from the Baseline StP Survey), plus questions about satisfaction and about intention to use what was discussed in the session. Each time they are asked to complete a survey, participants will be given the option of not filling them out without recourse. 

To keep their answers private, when participants complete their survey, they can seal it in a blank envelope before returning it to the facilitator. The facilitator will send all surveys in their sealed envelopes to the research team.

View the Post-LC Survey consent forms here:

Parental consent

Youth (under 18) assent

Adult (18+) consent

Follow-Up data collection

Approximately 1 month after the intervention concludes, we invite all those who attend PC CARES sessions and those who completed the Baseline StP Survey to fill out a Follow-Up Survey. This survey is identical to the Baseline StP Survey, and participants' responses are paired with their responses from before using anonymous ID codes. We hope to learn how PC CARES impacts those who attend the learning circles, the people close to them, and others in the community.

View the Follow-Up StP Survey consent forms here:

Parental consent

Youth (under 18) assent

Adult (18+) consent

Sharing study results

Final results will be shared through peer-reviewed publications and presentations, community presentations and tribal reports. Raw data will be considered for sharing under the following rules. Raw datasets released for sharing will not contain identifiers. Data and associated documentation will be made available to users only under a signed and properly executed data-sharing agreement that provides specific criteria under which the data will be used, including but not limited to: (1) a commitment to secure the data using appropriate computer technology, (2) a commitment to using the data for research purposes that are in accordance with collaborating tribes' priorities, (3) that the data is not used to identify individual participants and conforms to all privacy protections indicated in the participants' informed consent, and (4) a commitment to destroying or returning the data after analyses are completed.

Further information about the study results can be found on the Research and Evaluation page, which is updated regularly.