Community Partner Perspectives on Implementation Determinants of a Strengths-Based, Trauma-Informed School Suicide Prevention Intervention.

Background: Research has revealed persistent disparities in meeting the needs of racially minoritized youth identified with suicide risk in schools. An evidence-based trauma-informed suicide prevention practice, such as SAFETY-A (Safe Alternatives for Teens and Youth-Acute), may reduce unmet need and promote equitable care outcomes. Yet, it is highly challenging to implement practice innovations in under-resourced non-specialty settings, such as schools. Method: We conducted a multi-level assessment of barriers to implementing SAFETY-A in school districts serving predominantly immigrant families of color. School-based providers ( Results: Eleven themes were identified across multiple determinant levels. Findings show that implementation barriers are interrelated across determinant levels. Major barriers were related to the lack of resources in schools; the historical context of system over-involvement with communities of color that contribute to (l)earned mistrust; and cultural and linguistic differences working with families. Conclusions: Results aligned with HEIF domains implicated in maintaining health disparities. Implementation strategies for SAFETY-A in schools should be responsive to these determinants of disparities.