Efficacy-Implementation Study for PC CARES in Rural Alaska
NCT ID: NCT06658808
Last Updated: 2025-06-15
Study Results
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Basic Information
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RECRUITING
NA
1075 participants
INTERVENTIONAL
2024-09-12
2031-05-31
Brief Summary
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Detailed Description
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AIM#2 focuses on diffusion of learning in six randomly selected communities over the same time period as the first aim. The recruitment criteria for participating in this community-wide data collection is to be a resident of the community and age 12 years or older (youth: ages 12-17, and adults: 18 and older). Our community-wide adult and youth measures assess the community-level mechanisms of change (social diffusion), and track youth outcomes. We hypothesize that PC CARES learning circles will encourage adults to develop collaborative relationships within a CoP to implement upstream suicide prevention best practices (SPBPs) in support of youth in their lives. Using community level social network measures, we document the number and type of interactions reported by adults (n=450) over time, capturing social diffusion by comparing the knowledge, self-efficacy, CoP and prevention-oriented behaviors of (1) PC CARES participants, (2) non-participants who are 'close to' participants and (3) others, unrelated to participants (comparison group). In both the Adult and Youth Follow-up Surveys, we characterize closeness (close associates/youth 'close to' participants versus unrelated adults and youth) by asking respondents (Y/N) if they are close to a list of PC CARES participants from their community (i.e. people who attended 4+ LCs). 'Close to' is defined as someone with whom the participant feels closely connected to and interacts with at least weekly.
To assess youth impact (n=300, ages 12-17), we measure youth-reported supportive adult interactions and connectedness (over 7 time points), and pre-post perceived social support, family and community protective factors, comparing outcomes for youth who are 'close to' LC participants versus 'unrelated' youth (comparison group).
AIM#3 combines community-engaged methodologies and evidence-based implementation science frameworks to examine the barriers and enablers of PC CARES implementation in Alaska Native communities. AIM#3 examines implementation outcomes and contextual determinants to further understand how to successfully support community-driven diffusion of SPBPs in extremely rural and remote AN villages. Our evaluation will blend PC CARES' community-engaged approach with two evidence-based and widely used Implementation Science (IS) frameworks (RE-AIM; CFIR 2.0). Using participatory methods, we will sequentially and iteratively seek insights from our community partners, including: Rural Human Service (RHS) Students, RHS instructional teams (Elders; University of Alaska Fairbanks (UAF) Practicum Faculty, mentors), and Community Steering Committee (CSC) members. All RHS student facilitators will be invited to participate in each stage of research, and if interested will be invited to join the Community Steering Committee (CSC). As the RHS student facilitation teams implement LCs as part of their practicum, biweekly zoom/phone calls will support and track RHS student experiences and insights and offer opportunities for peer and mentor support. Monthly written reports will capture each student's community-based actions (e.g., recruitment process, sharing ideas from LCs with the tribal council), their experience of hosting LCs, including 'what worked' (enablers) and implementation barriers. In these various ways, they will reflect on key contextual determinants they are navigating, and how those affect their implementation of PC CARES. Lessons learned or puzzling findings from each of 5 RHS cohorts will be shared with the LSC to gain further insights and to inform the next wave of data collection and analysis. After each wave of implementation, we will conduct focus groups with RHS student facilitators about their overall experience using semi-structured guides informed by our preliminary RE-AIM outcomes (Reach, Effectiveness, Diffusion, Adoption, Implementation and Maintenance). We will transcribe focus groups recordings verbatim and use Dedoose, a qualitative analytic software, for deductive analysis using the RE(D)-AIM construct structure.
Conditions
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Study Design
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NON_RANDOMIZED
PARALLEL
PREVENTION
NONE
Study Groups
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PC CARES Intervention
PC CARES Intervention Participants will attend 1-5 sessions of the PC CARES curriculum, either virtually or in-person. Investigators will collect data from this group at baseline, after each session they attend, and at follow-up.
Promoting Community Conversations About Research to End Suicide
Promoting Community Conversations About Research to End Suicide (PC CARES) trains local community health workers to facilitate a series of five 3-hour Learning Circles (LCs) over \~6 months to develop a 'community of practice' (CoP), whereby trusted adults of youth (a) learn about SPBPs; (b) tailor the SPBPs to their culture and community; (c) build cross-sector relationships (parents, teachers, etc.), and (d) do more to prevent suicide. Each session shares evidence-based, actionable ways to enhance social support, reduce harm/risk, and promote help seeking, which participants adapt and apply in their daily interactions with youth.
No Intervention
This group will not attend the PC CARES sessions. Investigators will collect data from adults and youth at baseline, at 5 monthly timepoints as learning circles are being conducted in the community, and at follow-up (after 1 month and 6 months).
No interventions assigned to this group
Interventions
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Promoting Community Conversations About Research to End Suicide
Promoting Community Conversations About Research to End Suicide (PC CARES) trains local community health workers to facilitate a series of five 3-hour Learning Circles (LCs) over \~6 months to develop a 'community of practice' (CoP), whereby trusted adults of youth (a) learn about SPBPs; (b) tailor the SPBPs to their culture and community; (c) build cross-sector relationships (parents, teachers, etc.), and (d) do more to prevent suicide. Each session shares evidence-based, actionable ways to enhance social support, reduce harm/risk, and promote help seeking, which participants adapt and apply in their daily interactions with youth.
Eligibility Criteria
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Inclusion Criteria
12 Years
ALL
Yes
Sponsors
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Yukon Kuskokwim Health Corporation
OTHER
Norton Sound Health Corporation
OTHER
Maniilaq Association
UNKNOWN
University of Alaska Fairbanks
OTHER
National Institute of Mental Health (NIMH)
NIH
University of Michigan
OTHER
Responsible Party
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Lisa Wexler
Research Professor, Research Center for Group Dynamics, Institute for Social Research and Professor of Social Work
Principal Investigators
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Lisa Wexler, PhD
Role: PRINCIPAL_INVESTIGATOR
Univer
Locations
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Rural Human Services Program
Fairbanks, Alaska, United States
University of Michigan
Ann Arbor, Michigan, United States
Countries
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Central Contacts
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Facility Contacts
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References
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Markowski KL, White L, Harcey SR, Schmidt T, McEachern D, Habecker P, Wexler L. What Kinds of Support are Alaska Native Youth and Young Adults Reporting? An Examination of Types, Quantities, Sources, and Frequencies of Support. Health Promot Pract. 2023 Sep;24(5):863-872. doi: 10.1177/15248399221115065. Epub 2022 Sep 1.
Wexler L, Rataj S, Ivanich J, Plavin J, Mullany A, Moto R, Kirk T, Goldwater E, Johnson R, Dombrowski K. Community mobilization for rural suicide prevention: Process, learning and behavioral outcomes from Promoting Community Conversations About Research to End Suicide (PC CARES) in Northwest Alaska. Soc Sci Med. 2019 Jul;232:398-407. doi: 10.1016/j.socscimed.2019.05.028. Epub 2019 May 23.
Wells CC, White L, Schmidt T, Rataj S, McEachern D, Wisnieski D, Garnie J, Kirk T, Moto R, Wexler L. Adapting PC CARES to Continue Suicide Prevention in Rural Alaska During the COVID-19 Pandemic: Narrative Overview of an In-Person Community-Based Suicide Prevention Program Moving Online. Am Indian Alsk Native Ment Health Res. 2022;29(2):126-154. doi: 10.5820/aian.2902.2022.126.
Wexler L, McEachern D, DiFulvio G, Smith C, Graham LF, Dombrowski K. Creating a Community of Practice to Prevent Suicide Through Multiple Channels: Describing the Theoretical Foundations and Structured Learning of PC CARES. Int Q Community Health Educ. 2016;36(2):115-22. doi: 10.1177/0272684X16630886. Epub 2016 Feb 15.
Trout L, McEachern D, Mullany A, White L, Wexler L. Decoloniality as a Framework for Indigenous Youth Suicide Prevention Pedagogy: Promoting Community Conversations About Research to End Suicide. Am J Community Psychol. 2018 Dec;62(3-4):396-405. doi: 10.1002/ajcp.12293.
White LA, Wexler L, Weaver A, Moto R, Kirk T, Rataj S, Trout L, McEachern D. Implementation beyond the clinic: Community-driven utilization of research evidence from PC CARES, a suicide prevention program. Am J Community Psychol. 2022 Dec;70(3-4):365-378. doi: 10.1002/ajcp.12609. Epub 2022 Jun 28.
Related Links
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Description: Site describing the PC CARES philosophy, curriculum, team, and how people can get involved
Other Identifiers
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HUM00247458
Identifier Type: -
Identifier Source: org_study_id
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