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澳大利亚青少年自伤地图集:利用空间建模和制图技术呈现自伤流行率以及相关风险和保护因素,为青少年自杀预防策略提供信息。

Australian Youth Self-Harm Atlas: spatial modelling and mapping of self-harm prevalence and related risk and protective factors to inform youth suicide prevention strategies.

机构信息

QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.

School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.

出版信息

Epidemiol Psychiatr Sci. 2024 Sep 9;33:e34. doi: 10.1017/S2045796024000301.

Abstract

AIMS

Suicide prevention strategies have shifted in many countries, from a national approach to one that is regionally tailored and responsive to local community needs. Previous Australian studies support this approach. However, most studies have focused on suicide deaths which may not fully capture a complete understanding of prevention needs, and few have focused on the priority population of youth. This was the first nationwide study to examine regional variability of self-harm prevalence and related factors in Australian young people.

METHODS

A random sample of Australian adolescents (12-17-year-olds) were recruited as part of the Young Minds Matter (YMM) survey. Participants completed self-report questions on self-harm (i.e., non-suicidal self-harm and suicide attempts) in the previous 12 months. Using mixed effects regressions, an area-level model was built with YMM and Census data to produce out-of-sample small area predictions for self-harm prevalence. Spatial unit of analysis was Statistical Area Level 1 (average population 400 people), and all prevalence estimates were updated to 2019.

RESULTS

Across Australia, there was large variability in youth self-harm prevalence estimates. Northern Territory, Western Australia, and South Australia had the highest estimated state prevalence. Psychological distress and depression were factors which best predicted self-harm at an individual level. At an area-level, the strongest predictor was a high percentage of single unemployed parents, while being in an area where ≥30% of parents were born overseas was associated with reduced odds of self-harm.

CONCLUSIONS

This study identified characteristics of regions with lower and higher youth self-harm risk. These findings should assist governments and communities with developing and implementing regionally appropriate youth suicide prevention interventions and initiatives.

摘要

目的

在许多国家,自杀预防策略已经从国家层面转变为针对特定地区并响应当地社区需求的方法。先前的澳大利亚研究支持这种方法。然而,大多数研究都集中在自杀死亡上,这可能无法完全了解预防需求,而且很少有研究关注青少年这一重点人群。这是第一项在全国范围内研究澳大利亚年轻人自我伤害流行率及其相关因素的地区差异的研究。

方法

作为 Young Minds Matter (YMM) 调查的一部分,随机抽取澳大利亚青少年(12-17 岁)作为样本。参与者完成了关于过去 12 个月内自我伤害(即非自杀性自我伤害和自杀未遂)的自我报告问题。使用混合效应回归,使用 YMM 和人口普查数据构建了一个地区水平模型,以对自我伤害流行率进行样本外小区域预测。分析的空间单元是统计区域一级(平均人口 400 人),所有流行率估计值均更新至 2019 年。

结果

在澳大利亚各地,青少年自我伤害流行率的估计值存在很大差异。北领地、西澳大利亚州和南澳大利亚州的州估计患病率最高。心理困扰和抑郁是个体层面预测自我伤害的最佳因素。在地区层面上,最强的预测因素是单身失业父母的比例较高,而在父母中至少有 30%是海外出生的地区,自我伤害的可能性较低。

结论

本研究确定了具有较低和较高青少年自我伤害风险的地区特征。这些发现应该有助于政府和社区制定和实施适合地区的青少年自杀预防干预措施和计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27f2/11450422/dccf9c0c91b1/S2045796024000301_fig1.jpg

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