Collaborating with Immigrant Parents and Community Health Workers for Youth Suicide Prevention

There is a dearth of suicide prevention interventions tailored to meet the needs of immigrant-origin youth, who experience mental health treatment access gaps and unique risk and protective factors in the US social context. Immigrant-origin youth, born in another country or born in the United States (US) to foreign-born parents, make up 27% of the US population under the age of 18. Preventive interventions delivered in community settings and building on family strengths may be an effective way to deliver culturally congruent suicide prevention programming while addressing health service access barriers such as shortages of bilingual providers and lack of insurance. Designing programs to be led by community health workers, who are public health service providers that are frequently members of the community they serve, increases the fit of the intervention with the intended audience and context. To this end, the aims of this study are 1) to adapt a brief youth suicide prevention program for delivery by community health workers to Latinx immigrant parents 2) to pilot the delivery of this program to fifteen Latinx immigrant parents in community settings. To accomplish the first aim, we will adapt a family therapy program developed for immigrant families in which an adolescent child is experiencing suicidal ideation developed by study PI Kiara Alvarez. Four intervention modules (i.e., safety planning and means restriction, parent-child communication, problem solving, and family routines and rituals) will be adapted to be delivered as a brief prevention program by community health workers. A Community Advisory Board (CAB) composed of immigrant Latinx parents and community health workers will be convened and will work in a co-design process with the clinician-researcher team. The CAB and the investigators will adapt the modules, conduct key informant interviews for iterative feedback, and identify and address potential implementation challenges. To accomplish the second aim, we will work with the CAB to recruit 15 immigrant Latinx parent participants to participate in a pilot test of the program. We will assess the feasibility and acceptability of the program, as well as any effect on the intervention targets, via quantitative surveys administered before and after the intervention (to both parents and their adolescent children) and qualitative interviews. Survey data domains will include suicide prevention knowledge and skills, family functioning, parent-child communication, and intergenerational cultural conflict (a risk factor specific to the experience of immigrant families). We hypothesize that this intervention will be feasible and acceptable to parents. We will explore potential effects on the intervention targets, hypothesizing increases in suicide prevention knowledge and skills, improvement in family functioning and parent-child communication, and decreases in intergenerational cultural conflict. The goal of this project is to develop a culturally and contextually relevant, family-focused suicide prevention program for immigrant Latinx parents that can be widely adapted to community settings and potentially to other immigrant cultural groups. In the long term, our goal is to build the evidence base for community health worker-delivered youth suicide prevention programming and to contribute to multilevel, multisystem models of suicide prevention for immigrant-origin youth.