Evidence map›Paper›PMID 41223904›Full record

ArticleAnnals of epidemiology2025

Planning for the sustainability of a youth suicide prevention program in Native American contexts: A modeling study.

Lauren Yan, Zhixi Chen, Novalene Goklish, Kristin Mitchell, Charity Watchman, Meredith Stifter, Victoria O'Keefe, Allison Barlow, Mary Cwik, Takeru Igusa and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Lauren YanJohns Hopkins University, Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe St., Baltimore, MD 21205, USA.
Zhixi ChenJohns Hopkins University, Whiting School of Engineering, Department of Civil Engineering, 3400 N. Charles St., Baltimore, MD 21218, USA.
Novalene GoklishJohns Hopkins Center for Indigenous Health, Bloomberg School of Public Health, 415 N. Washington, 4th Floor, Baltimore, MD 21205, USA.
Kristin MitchellJohns Hopkins Center for Indigenous Health, Bloomberg School of Public Health, 415 N. Washington, 4th Floor, Baltimore, MD 21205, USA.
Charity WatchmanJohns Hopkins Center for Indigenous Health, Bloomberg School of Public Health, 415 N. Washington, 4th Floor, Baltimore, MD 21205, USA.
Meredith StifterJohns Hopkins Center for Indigenous Health, Bloomberg School of Public Health, 415 N. Washington, 4th Floor, Baltimore, MD 21205, USA.
Victoria O'KeefeJohns Hopkins Center for Indigenous Health, Bloomberg School of Public Health, 415 N. Washington, 4th Floor, Baltimore, MD 21205, USA.
Allison BarlowJohns Hopkins Center for Indigenous Health, Bloomberg School of Public Health, 415 N. Washington, 4th Floor, Baltimore, MD 21205, USA.
Mary CwikJohns Hopkins Center for Indigenous Health, Bloomberg School of Public Health, 415 N. Washington, 4th Floor, Baltimore, MD 21205, USA.
Takeru IgusaJohns Hopkins University, Whiting School of Engineering, Department of Civil Engineering, 3400 N. Charles St., Baltimore, MD 21218, USA.
Emily E HarozJohns Hopkins University, Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; Johns Hopkins Center for Indigenous Health, Bloomberg School of Public Health, 415 N. Washington, 4th Floor, Baltimore, MD 21205, USA. Electronic address: eharoz1@jhu.edu.

Funding

Global Mental Health Training ProgramT32MH103210 · NIMH · JOHNS HOPKINS UNIVERSITY · PI Judith Karen Bass, Sarah Sutherlin-McIvor Murray · 2015 to 2026
$4.0M
Integrating data for causal inference in behavioral healthT32MH122357 · NIMH · JOHNS HOPKINS UNIVERSITY · PI Rashelle Jean Musci, Elizabeth A. Stuart · 2020 to 2026
$1.8M
SuSt-AInS: Sustainment of suicide prevention programs in American Indian SettingsK01MH116335 · NIMH · JOHNS HOPKINS UNIVERSITY · PI HAROZ, EMILY · 2018 to 2022
$733k
Social determinants, trauma, and mental distress among forcibly displaced populations in low- and middle-income countriesF31MH136678 · NIMH · JOHNS HOPKINS UNIVERSITY · PI YAN, LAUREN NICOLE · 2024 to 2025
$99k
NIMH NIH HHS F31 MH136678NIMH NIH HHS K01 MH116335NIMH NIH HHS T32 MH103210NIMH NIH HHS T32 MH122357
6 · The paper itself

Abstract

purposeWe aimed to identify actionable, effective sustainment strategies for a community-based suicide prevention program implemented in Tribal contexts through a participatory process of system dynamics modeling.

methodsThrough a series of workshops with teams implementing a suicide prevention program, we prioritized strategies for sustaining implementation and related health outcomes. We used system dynamics modeling and microsimulations to assess the impact of key strategies (increased funding, enhanced program management, and leadership development) on program sustainment outcomes and suicidal behavior among youth.

resultsEnhanced program management impacted sustainment by increasing simulated levels of community trust by 31 % and community and external collaborators by 10 %. Increased funding increased simulated resource availability by 46 % and staffing levels by 13 % over the simulated time frame. Among the three simulated sustainment strategies, enhanced program management most improved clinical outcomes, decreasing non-suicidal self-injury by 1.4 % and suicide attempts by 1.3 %.

conclusionsWe collaboratively developed a simulation model that assessed the relative impact of stakeholders' prioritized sustainment strategies. A multifaceted intervention for enhanced program management had the greatest impact on program sustainment outcomes. This approach can benefit Tribal communities who are considering methods to support vital community-based programs.

Indexed as

Indians, North AmericanSuicide PreventionAdolescentFemaleHumansMaleProgram DevelopmentProgram EvaluationSuicideSuicide, AttemptedAmerican Indian and Alaska Native; WMATBrief InterventionCenters for Disease Control and Prevention; NHSColumbia Classification Algorithm for Suicide Assessment; GLSGarrett Lee Smith Memorial Act; CDCJohns Hopkins Center for Indigenous Health; C-CASANational Health Service; SBIRTProgram Sustainability Assessment Tool; SDPublic Health Program Capacity for Sustainability; PSATReferral to Treatment; PHPCSScreeningsystem dynamics; IHS Indian Health Service.System dynamics; Microsimulation; Community-based participatory research; Native American; Suicide prevention; Surveillance; Sustainability LIST OF ABBREVIATIONS AND ACRONYMS: AI/ANWhite Mountain Apache Tribe; JHCIH

Identifiers

PMID41223904
PMCPMC12744210

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.