'Wero' Faith Community Suicide Prevention Outreach and Social Engagement for Korean American Older Adults

Background. Korean American (KA) older adults face the highest suicide rates among U.S. racial and ethnic groups, with rates nearly doubling over the past decade. The church plays a central role in the cultural and religious lives of KA older adults, yet no suicide prevention programs have effectively leveraged the church infrastructure. The goal of this project is to adapt and test culturally relevant suicide prevention interventions within the KA faith community: (1) Pilot test the culturally adapted 'Soul Shop', designed to cultivate a suicide-safe culture in faith communities, for KA older adults; and (2) Adapt 'Engage Coaching, an evidence-based intervention to promote socially rewarding behaviors in late life as a suicide prevention strategy, for delivery by faith leaders to those identified at elevated suicide risk. Specific Aims. Phase I: (1) Conduct a pilot randomized controlled trial of adapted Soul Shop+Safety Monitoring and Management (SMM) compared to SMM only on measures of acceptability, suicide literacy, and suicide stigma at post-training and 1-month follow up; (2) Refine cultural adaptation of Soul Shop with feedback from faith leaders and community stakeholders; Phase II: (3) Adapt Engage Coaching for KA older adults, incorporating feedback from KA faith leaders and community stakeholders; and, (4) Assess the suitability of Engage Coaching for delivery by faith leaders, identifying potential challenges and training needs. Procedures. Recruitment efforts will be made with the Council of Korean Churches in Greater Washington, a network of 250 Korean churches. 50 consenting KA older adults will be randomized into Soul Shop+SMM or SMM only condition. The Soul Shop intervention will be delivered by an ordained KA pastor and a clinical psychologist. Adaptations to Soul Shop and Engage Coaching will follow Barrera’s cultural adaptation model, with ongoing input from a Community Advisory Board, faith leaders, and original intervention developers. Sample & Measures. Phase I. Acceptability of Soul Shop will be assessed quantitatively (helpfulness, relevance, satisfaction, and recommendation to others) and qualitatively at exit interview (insight, satisfaction). Feedback from 12 KA faith leaders will guide further refinement of Soul Shop. Phase II. Once Engage Coaching intervention is linguistically translated, 12 KA faith leaders will provide feedback on adaptation needs using the model for adaptation design and impact (MADI). A rapid qualitative analysis will synthesize and document the adaptation workgroup’s decisions. Lastly, a brief survey and focus groups with 12 KA faith leaders will assess the suitability of Engage Coaching for delivery by faith leaders and dissemination strategies. The deliverables of this proposed project are: (1) adapted and pilot-tested Soul Shop; and (2) preliminarily adapted Engage Coaching protocols and summarized faith leader feedback on its suitability, messaging strategies, and faith leader partnership building and training needs. Potential Impact. This project has the potential to enhance the identification, response, and referral of KA older adults at risk for suicide in a culturally appropriate manner. It also offers a model for integrating faith-based communities into suicide prevention efforts, with potential applications to other minority faith communities in the U.S. and internationally.