Adams Leslie, Igbinedion Godwin, DeVinney Aubrey, Azasu Enoch, Nestadt Paul, Thrul Johannes, Joe Sean
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
Washington University at St. Louis, St. Louis, MO, United States.
JMIR Res Protoc. 2021 Oct 20;10(10):e31241. doi: 10.2196/31241.
BACKGROUND: Suicide is the third leading cause of death among Black adults aged 18-35 years. Although men represent a majority of suicide deaths among Black adults, less is known regarding the extent to which unique cultural stressors, such as racism-related stress (eg, racial discrimination), are salient in exacerbating suicide risk among Black men. Moreover, few studies examine the daily influence of racism-related stressors on suicide outcomes using real-time smartphone-based approaches. Smartphone-based mobile health approaches using ecological momentary assessments (EMA) provide an opportunity to assess and characterize racism-related stressors as a culturally sensitive suicide risk factor among Black young adult men. OBJECTIVE: The goal of this study is to describe a protocol development process that aims to capture real-time racism-related stressors and suicide outcomes using a smartphone-based EMA platform (MetricWire). METHODS: Guided by the Interpersonal Theory of Suicide (ITS), we developed a brief EMA protocol using a multiphased approach. First, we conducted a literature review to identify brief measures previously used in EMA studies, with special emphasis on studies including Black participants. The identified measures were then shortened to items with the highest construct validity (eg, factor loadings) and revised to reflect momentary or daily frequency. Feasibility and acceptability of the study protocol will be assessed using self-report survey and qualitative responses. To protect participants from harm, a three-tier safety protocol was developed to identify participants with moderate, elevated, and acute risk based on EMA survey response to trigger outreach by the study coordinator. RESULTS: The final EMA protocol, which will be completed over a 7-day period, is comprised of 15 questions administered 4 times per day and a daily questionnaire of 22 items related to sleep-related impairment and disruption, as well as racism-related stress. Study recruitment is currently underway. We anticipate the study will be completed in February 2023. Dissemination will be conducted through peer-reviewed publications and conference presentations. CONCLUSIONS: This protocol will address gaps in our understanding of Black men's suicide outcomes in the social contexts that they regularly navigate and will clarify the temporal role of racism-related stressors that influence suicidal outcomes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/31241.
背景:自杀是18至35岁黑人成年人的第三大死因。尽管在黑人成年人自杀死亡案例中男性占多数,但对于诸如与种族主义相关的压力(如种族歧视)等独特文化压力源在加剧黑人男性自杀风险方面的显著程度,我们了解得较少。此外,很少有研究使用基于智能手机的实时方法来考察与种族主义相关的压力源对自杀结果的日常影响。基于智能手机的移动健康方法采用生态瞬时评估(EMA),为将与种族主义相关的压力源评估和表征为黑人青年男性中一种具有文化敏感性的自杀风险因素提供了契机。 目的:本研究的目标是描述一个方案开发过程,该过程旨在使用基于智能手机的EMA平台(MetricWire)来捕捉与种族主义相关的实时压力源和自杀结果。 方法:在自杀人际理论(ITS)的指导下,我们采用多阶段方法开发了一个简短的EMA方案。首先,我们进行了文献综述,以确定EMA研究中先前使用的简短测量方法,特别关注包括黑人参与者的研究。然后将确定的测量方法缩短为具有最高结构效度(如因子载荷)的条目,并进行修订以反映瞬时或每日频率。将使用自我报告调查和定性回答来评估研究方案的可行性和可接受性。为保护参与者免受伤害,制定了一个三层安全方案,根据EMA调查回复来识别具有中度、升高和急性风险的参与者,以便触发研究协调员进行干预。 结果:最终的EMA方案将在7天内完成,包括每天进行4次的15个问题,以及一份关于与睡眠相关的损害和干扰以及与种族主义相关的压力的22项每日问卷。目前正在进行研究招募。我们预计该研究将于2023年2月完成。将通过同行评审出版物和会议报告进行传播。 结论:本方案将填补我们在理解黑人男性在其日常所处社会环境中的自杀结果方面的空白,并将阐明与种族主义相关的压力源对自杀结果的时间作用。 国际注册报告识别码(IRRID):PRR1-10.2196/31241
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