Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 4;4(1):1.
doi: 10.1186/s43058-022-00376-1.

Planning for implementation and sustainability of a community-based suicide surveillance system in a Native American community

Teresa Brockie  1   2 , Ellie Decker  3 , Allison Barlow  4 , Mary Cwik  4 , Adriann Ricker  3 , Theresa Aguilar  3 , Lawrence Wetsit  3 , Deborah Wilson  3 , Emily E Haroz  5   4
Affiliations

Planning for implementation and sustainability of a community-based suicide surveillance system in a Native American community

Teresa Brockie et al. Implement Sci Commun. .

Abstract

Background: Native American youth, primarily living on reservations, suffer the highest burden of suicide of any racial group in the USA. Implementation and sustainability of culturally grounded, evidence-based interventions are needed to address suicide in Native American populations. For nearly 40 years, Montana has ranked at or near the top nationwide for suicide. Fort Peck Tribal leadership declared a state of emergency in 2010 after six suicides and 20 attempts that occurred over a 5-month period.

Methods: We used a community-based participatory research approach for adapting the Celebrating Life (CL) program with a specific focus on long-term sustainability, which has demonstrated efficacy in addressing suicide with the White Mountain Apache. The aims were to (1) adapt the CL program intake forms through roundtable discussions, (2) conduct asset and resource mapping to identify community and cultural resources to leverage for the CL program within the Fort Peck context, and (3) develop a sustainability plan for CL in Fort Peck through qualitative approaches informed by the Program Sustainability Assessment Tool.

Results: Roundtable discussions resulted in adapted intake forms that capture variables relevant to the Fort Peck context. Asset mapping identified 13 community assets and 10 cultural resources to incorporate within the CL implementation process. Focus group discussions yielded four key themes that were incorporated into a plan for sustainability: (1) strategic partnerships, (2) long-term funding, (3) communication planning, and (4) workforce planning and engagement.

Conclusions: This paper outlines an avenue for using culturally adapted tools to design an implementation system driven by community and cultural assets within tribal communities and for integrating program planning for sustainability early in the implementation process.

Keywords: Community and cultural asset mapping; Community-based participatory research; Native American; Suicide prevention; Surveillance; Sustainability.

PubMed Disclaimer

Conflict of interest statement

The study was authorized by the Fort Peck Executive Board through Tribal Resolution (29-155-2017-12). All study team members have completed required training on human subjects’ research, conflicts of interest, and health privacy issues. Study team members completed consent with all participants prior to the start of data collection, which included consent to publication of findings. Human subjects review was conducted by the Fort Peck Tribal IRB (July 2019) and Johns Hopkins School of Medicine IRB (#00200073). Any modifications to study protocols were submitted to both IRB’s for approval prior to implementation. Fort Peck Tribal IRB reviews all manuscripts prior to publication.

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Fort Peck Logic Model. Bolded items show anticipated outputs and outcomes/impact as a result of CL implementation
Fig. 2
Fig. 2
Research study process flow
See this image and copyright information in PMC

References

    1. Herne MA, Bartholomew ML, Weahkee RL. Suicide mortality among American Indians and Alaska Natives, 1999-2009. Am J Public Health. 2014;104(Suppl 3):S336–S342. doi: 10.2105/AJPH.2014.301929. - DOI - PMC - PubMed
    1. Cwik M, Barlow A, Tingey L, Goklish N, Larzelere-Hinton F, Craig M, et al. Exploring risk and protective factors with a community sample of American Indian adolescents who attempted suicide. Arch Suicide Res. 2015;19(2):172–189. doi: 10.1080/13811118.2015.1004472. - DOI - PubMed
    1. Freedenthal S, Stiffman AR. "They might think I was crazy": Young American Indians' reasons for not seeking help when suicidal. J Adolesc Res. 2007;22(1):58–77. doi: 10.1177/0743558406295969. - DOI
    1. Wexler L, Chandler M, Gone JP, Cwik M, Kirmayer LJ, LaFromboise T, et al. Advancing suicide prevention research with rural American Indian and Alaska Native populations. Am J Public Health. 2015;105(5):891–899. doi: 10.2105/AJPH.2014.302517. - DOI - PMC - PubMed
    1. Oré CE, Teufel-Shone NI, Chico-Jarillo TM. American Indian and Alaska Native resilience along the life course and across generations: a literature review. Am Indian Alsk Native Ment Health Res. 2016;23(3):134–157. doi: 10.5820/aian.2303.2016.134. - DOI - PMC - PubMed

LinkOut - more resources