Pinciotti Caitlin M, Buckland Erica, Mayes Taryn L, Cooley John L, Mitchell Sean M, Zullo Lucas, Hughes Jennifer L, Patel Puja G, Neal Colleen, DeFilippis Melissa, Babatope Taiwo T, Cruz Carmen, Trivedi Madhukar H, Storch Eric A, Goodman Wayne K, Williams Laurel L, Asarnow Joan R
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Evid Based Pract Child Adolesc Ment Health. 2025 Jun 28. doi: 10.1080/23794925.2025.2522068.
Suicide is a leading cause of death among youth, and rates continue to increase across the United States. Pediatric primary care providers (PCPs) are uniquely positioned to identify acute periods of increased suicidal ideation and provide timely intervention.
The present study assessed the feasibility and acceptability of training and implementation of a primary care-adapted version of Safe Alternatives for Teens and Youth-Acute (SAFETY-A), a brief, strengths-based, cognitive-behaviorally oriented, family intervention for suicidal thoughts and behaviors in youth, among pediatric PCPs.
This multisite pilot study involved collaboration between eight Texas-based academic institutions who assisted with the recruitment and training of 68 PCPs. PCPs attended five SAFETY-A training sessions and completed self-report surveys for 6 months post-training.
Prior to SAFETY-A training, PCPs indicated a significant training gap, with 83% indicating that they had not received sufficient prior training in suicide risk assessment and risk reduction/intervention. PCPs found SAFETY-A training acceptable, reporting significant improvements in knowledge, skills, and confidence. PCPs also found SAFETY-A implementation feasible, using the intervention a total of 288 times over the course of 6 months ( uses per PCP = 6.9). However, PCPs found the SAFETY-A training schedule less feasible, with many PCPs unable to attend all five training sessions.
Findings suggest that a tiered training structure allowing for more flexibility in training commitment might be more feasible for busy PCPs seeking training in SAFETY-A. Ongoing efforts to feasibly scale-up SAFETY-A training efforts across Texas incorporate these findings with the goal of making SAFETY-A training available to all PCPs across the state.
自杀是青少年死亡的主要原因，且美国各地的自杀率持续上升。儿科初级保健提供者（PCP）处于独特的地位，能够识别自杀意念增加的急性期并提供及时干预。
本研究评估了在儿科初级保健提供者中培训和实施针对青少年急性自杀问题的初级保健适应性版本“青少年安全替代方案-急性版（SAFETY-A）”的可行性和可接受性，SAFETY-A是一种简短的、基于优势的、认知行为导向的家庭干预措施，用于应对青少年的自杀想法和行为。
这项多地点试点研究涉及德克萨斯州的八所学术机构之间的合作，这些机构协助招募和培训了68名初级保健提供者。初级保健提供者参加了五次SAFETY-A培训课程，并在培训后6个月完成自我报告调查。
在接受SAFETY-A培训之前，初级保健提供者表示存在显著的培训差距，83%的人表示他们之前在自杀风险评估和风险降低/干预方面没有接受过足够的培训。初级保健提供者认为SAFETY-A培训是可接受的，报告称在知识、技能和信心方面有显著提高。初级保健提供者还认为SAFETY-A的实施是可行的，在6个月的时间里总共使用了该干预措施288次（每个初级保健提供者的使用次数=6.9次）。然而，初级保健提供者发现SAFETY-A的培训计划不太可行，许多初级保健提供者无法参加所有五次培训课程。
研究结果表明，对于寻求SAFETY-A培训的忙碌初级保健提供者来说，允许在培训承诺方面有更大灵活性的分层培训结构可能更可行。正在进行的在德克萨斯州切实扩大SAFETY-A培训工作的努力将纳入这些研究结果，目标是让该州所有初级保健提供者都能接受SAFETY-A培训。
