Search

This paper presents how a community mobilization program to prevent suicide was adapted to an online format to accommodate the impossibility of in-person delivery in Alaska Native communities during the COVID-19 pandemic. The intervention, Promoting Community Conversations About Research to End Suicide (PC CARES), was created collaboratively by researchers and Alaska Native communities with the goal of bringing community members together to create research-informed and community-led suicide prevention activities in their communities. To continue our work during the COVID-19 pandemic and restrictions, we adapted the PC CARES model to a synchronous remote delivery format. This shift included moving from predominantly Alaska Native participants to one of a mainly non-Native school staff audience. This required a pivot from Alaska Native self-determination toward cultural humility and community collaboration for school-based staff, with multilevel youth suicide prevention remaining the primary aim. This reorientation can offer important insight into how to build more responsive programs for those who are not from the communities they serve. Here, we provide a narrative overview of our collaborative adaptation process, illustrated by data collected during synchronous remote facilitation of the program, and reflect on how the shift in format and audience impacted program delivery and content. The adaptation process strove to maintain the core animating features of self-determination for Alaska Native communities and people as well as the translation of scientific knowledge to practice for greater impact. [ABSTRACT FROM AUTHOR]

Because suicide is deeply connected to local, historical and relational contexts, effective suicide prevention strategies must balance maintaining fidelity of evidence-based practices and adapting for the unique needs of diverse communities. Promoting Community Conversations About Research to End Suicide (PC CARES) builds the capacity of local people in close-knit rural Alaska Native communities to take preventative actions based on existing relationships, roles, and priorities. In a series of learning circles, community members learn about multilevel evidence-based suicide prevention practices, apply the information to personal and cultural contexts, and develop plans for taking action--on their own terms--in their lives. Here, we describe the participatory process used to adapt PC CARES from one region of Alaska to another, aiming to maximize transferability, practicality and relevance in our partner communities. With the shared goal of promoting self-determined, evidence-informed, community-based suicide prevention, the adaptation process included negotiating between comprehensiveness and understandability; subject appeal and utility; predictability and customizability, through consensus-building with researchers and community members. Lessons learned can be helpful to others working to navigate community-specific priorities and evidence-based approaches to develop interventions that can work across many different communities. [ABSTRACT FROM AUTHOR]

Indigenous youth suicide remains a substantial health disparity in circumpolar communities, despite prevention efforts through primary health care, public health campaigns, school systems, and social services. Innovations in prevention practice move away from expert-driven approaches to emphasize local control through processes that utilize research evidence, but privilege self- determined action based on local and personal contexts, meanings, and frameworks for action. "Promoting Community Conversations About Research to End Suicide" is a community health intervention that draws on networks of Indigenous health educators in rural Alaska, who host learning circles in which research evidence is used to spark conversations and empower community members to consider individual and collective action to support vulnerable people and create health-promoting conditions that reduce suicide risk. The first of nine learning circles focuses on narratives of local people who link the contemporary youth suicide epidemic to 20th century American colonialism, and situates prevention within this context. We describe the theoretical framework and feasibility and acceptability outcomes for this learning circle, and elucidate how the educational model engages community members in decolonial approaches to suicide prevention education and practice, thus serving as a bridge between Western and Indigenous traditions to generate collective knowledge and catalyze community healing., (© 2018 Society for Community Research and Action.)