Nurse and Peer Led Suicide Prevention in Tajikistan

Обзор

The study takes place in Tajikistan, a postwar country in Central Asia, where Dr. Weine, Dr. Pirova, Dr. Bahromov, and other collaborators successfully implemented a D43 research capacity building project and an R21 and R01 on stepped care for women's mental health in primary care. This study also builds on the team's prior research that demonstrated the effectiveness of nurse- and peer-led interventions, identified risk and protective factors for suicide among women, and on the PREVAIL peer-led suicide prevention model. The specific aims for this new project are: Aim 1: Adapt the evidence-based PREVAIL model into a new SUSTAIN nurse- and peer-led suicide prevention model in primary care for women at moderate or high suicide risk in rural and urban Tajikistan using a participatory co-design process (the Transcreation Framework) with multi-level partners. Aim 2: Evaluate a pilot implementation of the SUSTAIN model in primary care among 96 women with moderate to high suicide risk, 48 randomized to SUSTAIN and 48 to an enhanced usual care condition, with both groups followed for 9 months for suicidal ideations or behaviors, mental health outcomes, and mediators. Aim 3: Assess the acceptability, feasibility, appropriateness, potential for scalability and sustainability, programmatic costs, and partnership of SUSTAIN to inform a future hybrid type 2 effectiveness-implementation pragmatic trial.

Вмешательства

• Поведенческое Suicide prevention treatment
  SUSTAIN intervention is a nurse and peer-led individual, group and family sessions suicide prevention intervention. There are 9 sessions that are attended by the women (6 individual and 3 group) and 1 session that is attended by their family members; this will occur over the course of 8-12 weeks depending on timing and scheduling.
• Поведенческое Care as usual
  Enhanced usual care (EUC) control condition): In the 6 clinics assigned to the control condition, the women who screen positive for moderate to high suicide risk will receive enhanced usual care. They will be evaluated by a family medicine doctor who will confirm their level of risk and decide on appropriate actions. This could include an admission to inpatient psychiatry, a referral to outpatient psychiatry, or management in the family medicine clinic which may include counseling, psychiatric

Первичные конечные точки

• Columbia Suicide Severity Rating Scale [Срок оценки: Baseline and 3, 6, 9 months post intervention]

Вторичные конечные точки (12)

• Medically serious suicide attempts [Срок оценки: 3, 6, and 9 months post intervention]
• Suicide Cognitions Scale-Short Form (SCS-S) [Срок оценки: 3, 6, and 9 month post intervention]
• Beck Hopelessness Scale (BHS) [Срок оценки: 3, 6, 9 months post intervention]
• Brief Reasons for Living (BRFL) [Срок оценки: 3, 6, 9 month post intervention]
• Patient Health Questionnaire-9 (PHQ-9) [Срок оценки: 3, 6, 9 month post intervention]
• Generalized Anxiety Disorder-7 (GAD-7) [Срок оценки: 3, 6, 9 months post intervention]
• PTSD CheckList - Civilian Version (PCL-C) [Срок оценки: 3, 6, 9 months post intervention]
• Abuse Assessment Screen [Срок оценки: 3, 6, 9 month post intervention]
• Pearlin Mastery Scale [Срок оценки: 3, 6, 9 months post intervention]
• Mental Health Knowledge Schedule (MAKS) [Срок оценки: 3, 6, 9 months post intervention]
• Short Form Health Survey (SF-12) [Срок оценки: 3, 6, 9 months post intervention]
• Interpersonal Needs Questionnaire (INQ) [Срок оценки: 3, 6, 9 months post intervention]

Критерии участия

Критерии включения

• Tajik women age 18 to 59 who meet operationally defined criteria for moderate or high risk suicide risk. We will identify women at-risk for suicide defined as:

• a recent suicide attempt (past 3 months)
• recent suicidal ideation that is accompanied by either a plan or intention as assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS). If they score a level 2 or higher on the C-SSRS, they are eligible. Level 2 refers to non-specific active suicidal thoughts. At level 2, a person has general, active thoughts of wanting to end their life but has not formulated a specific plan, method, or intention to act on them.

Other inclusion criteria are: 1) willing to participate in the SUSTAIN intervention and research procedures; and 2) able to give written informed consent.

Критерии исключения

• If they score less than a level 2 on the C-SSRS they are not eligible

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Профилактика

Центры проведения

Tajikistan · 1 центр

• PRISMA research center — Dushanbe

Идентификаторы

NCT: NCT07453758 · 2025-0021 · R34MH136247

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗