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Published on: July 10, 2017
Planning for the sustainability of a youth suicide prevention program in Native American contexts: A modeling study
Lauren Yan1, Zhixi Chen2, Novalene Goklish3
1Johns Hopkins University, Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe St., Baltimore, MD 21205, USA.
Purpose:
We aimed to identify actionable, effective sustainment strategies for a community-based suicide prevention program implemented in Tribal contexts through a participatory process of system dynamics modeling.
Methods:
Through a series of workshops with teams implementing a suicide prevention program, we prioritized strategies for sustaining implementation and related health outcomes. We used system dynamics modeling and microsimulations to assess the impact of key strategies (increased funding, enhanced program management, and leadership development) on program sustainment outcomes and suicidal behavior among youth.
Results:
Enhanced program management impacted sustainment by increasing simulated levels of community trust by 31 % and community and external collaborators by 10 %. Increased funding increased simulated resource availability by 46 % and staffing levels by 13 % over the simulated time frame. Among the three simulated sustainment strategies, enhanced program management most improved clinical outcomes, decreasing non-suicidal self-injury by 1.4 % and suicide attempts by 1.3 %.
Conclusions:
We collaboratively developed a simulation model that assessed the relative impact of stakeholders' prioritized sustainment strategies. A multifaceted intervention for enhanced program management had the greatest impact on program sustainment outcomes. This approach can benefit Tribal communities who are considering methods to support vital community-based programs.
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