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.

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.

[1]  L. Wexler,et al.  Collaboratively Adapting Culturally-Respectful, Locally-Relevant Suicide Prevention for Newly Participating Alaska Native Communities , 2022, Journal for Social Action in Counseling & Psychology.

[2]  E. Burnett,et al.  Hospitalizations for COVID-19 Among American Indian and Alaska Native Adults (≥ 18 Years Old) — New Mexico, March–September 2020 , 2022, Journal of Racial and Ethnic Health Disparities.

[3]  E. Reininghaus,et al.  Psychological impact of the COVID-19 pandemic on individuals with serious mental disorders: A systematic review of the literature , 2021, World journal of psychiatry.

[4]  K. Chou,et al.  Global prevalence and associated risk factors of posttraumatic stress disorder during COVID-19 pandemic: A meta-analysis , 2021, International Journal of Nursing Studies.

[5]  Mary Ann Keogh Hoss,et al.  The inequitable impact of Covid-19 among American Indian/Alaskan Native (AI/AN) communities is the direct result of centuries of persecution and racism , 2021, Journal of the Royal Society of Medicine.

[6]  S. Farooq,et al.  Suicide, self-harm and suicidal ideation during COVID-19: A systematic review , 2021, Psychiatry Research.

[7]  P. Links,et al.  Innovations in suicide assessment and prevention during pandemics. , 2021, Public health research & practice.

[8]  L. Wexler,et al.  Protective Factors as a Unifying Framework for Strength-Based Intervention and Culturally Responsive American Indian and Alaska Native Suicide Prevention , 2021, Prevention Science.

[9]  Ryan G. Carlson,et al.  Coping during COVID: Implementation of an online relationship education intervention for couples. , 2021 .

[10]  P. Harmer,et al.  Implementing an Online Virtual Falls Prevention Intervention During a Public Health Pandemic for Older Adults with Mild Cognitive Impairment: A Feasibility Trial , 2021, Clinical interventions in aging.

[11]  Anna Wirta Kosobuski,et al.  The Impact of COVID-19 on American Indian and Alaska Native Communities: A Call for Better Relational Models. , 2021, American journal of public health.

[12]  P. Grady,et al.  State health disparities research in Rural America: Gaps and future directions in an era of COVID‐19 , 2021, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[13]  Erik Peper,et al.  Avoid Zoom Fatigue, Be Present and Learn , 2021, NeuroRegulation.

[14]  Syahirah Abdul Rahman,et al.  Resilient Research in the Field: Insights and Lessons From Adapting Qualitative Research Projects During the COVID-19 Pandemic , 2021, International Journal of Qualitative Methods.

[15]  Karim E. Fraoua How to Asses Empathy During Online Classes , 2021, HCI.

[16]  Allyson Kelley,et al.  Recruiting and Engaging American Indian and Alaska Native Teens and Young Adults in a SMS Help-Seeking Intervention: Lessons Learned from the BRAVE Study , 2020, International journal of environmental research and public health.

[17]  L. Sher,et al.  The impact of the COVID-19 pandemic on suicide rates , 2020, QJM : monthly journal of the Association of Physicians.

[18]  D. Operario,et al.  Research with Marginalized Communities: Challenges to Continuity During the COVID-19 Pandemic , 2020, AIDS and Behavior.

[19]  A. Lowell,et al.  Drafting the Aboriginal and Islander Mental Health Initiative for Youth (AIMhi-Y) App: Results of a formative mixed methods study , 2020, Internet interventions.

[20]  B. Rapkin Resolving the Rigor versus Respect Dilemma in Community-Based Research: Commentary on Bess and Colleagues , 2019, Progress in community health partnerships : research, education, and action.

[21]  C. Chow,et al.  A Smartphone App to Assist Smoking Cessation Among Aboriginal Australians: Findings From a Pilot Randomized Controlled Trial , 2018, JMIR mHealth and uHealth.

[22]  Jacob E. Barkley,et al.  College Students’ Multitasking Behavior in Online Versus Face-to-Face Courses , 2019, SAGE Open.

[23]  L. Wexler,et al.  Decoloniality as a Framework for Indigenous Youth Suicide Prevention Pedagogy: Promoting Community Conversations About Research to End Suicide , 2018, American journal of community psychology.

[24]  Hsuan-Wei Lee,et al.  Mapping the structure of perceptions in helping networks of Alaska Natives , 2018, PloS one.

[25]  J. Baldwin,et al.  Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities , 2018, Prevention Science.

[26]  I. Colman,et al.  Global incidence of suicide among Indigenous peoples: a systematic review , 2018, BMC Medicine.

[27]  L. Whitbeck,et al.  Pathways of Adaptation: Two Case Studies with One Evidence-Based Substance Use Prevention Program Tailored for Indigenous Youth , 2018, Prevention Science.

[28]  Janice D. McCall,et al.  Teaching critical self-reflection through the lens of cultural humility: an assignment in a social work diversity course , 2017 .

[29]  L. Wexler,et al.  Promoting Community Conversations About Research to End Suicide: learning and behavioural outcomes of a training-of-trainers model to facilitate grassroots community health education to address Indigenous youth suicide prevention , 2017, International journal of circumpolar health.

[30]  M. Barrera,et al.  Directions for the Advancement of Culturally Adapted Preventive Interventions: Local Adaptations, Engagement, and Sustainability , 2017, Prevention Science.

[31]  M. Kral Suicide and Suicide Prevention among Inuit in Canada , 2016, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[32]  K. Dombrowski,et al.  Creating a Community of Practice to Prevent Suicide Through Multiple Channels: Describing the Theoretical Foundations and Structured Learning of PC CARES , 2016, International quarterly of community health education.

[33]  L. Kirmayer,et al.  Mental Health Promotion for Indigenous Youth , 2016 .

[34]  M. Chandler,et al.  Advancing suicide prevention research with rural American Indian and Alaska Native populations. , 2015, American journal of public health.

[35]  L. Kirmayer,et al.  Rethinking Historical Trauma , 2014, Transcultural psychiatry.

[36]  Leopoldo J. Cabassa,et al.  A two-way street: bridging implementation science and cultural adaptations of mental health treatments , 2013, Implementation Science.

[37]  E. Bertone-Johnson,et al.  Factors Associated with Alaska Native Fatal and Nonfatal Suicidal Behaviors 2001–2009: Trends and Implications for Prevention , 2012, Archives of suicide research : official journal of the International Academy for Suicide Research.

[38]  L. Kirmayer Cultural competence and evidence-based practice in mental health: epistemic communities and the politics of pluralism. , 2012, Social science & medicine.

[39]  L. Wexler,et al.  Culturally responsive suicide prevention in indigenous communities: unexamined assumptions and new possibilities. , 2012, American journal of public health.

[40]  G. Bernal,et al.  Cultural adaptation in context: Psychotherapy as a historical account of adaptations. , 2012 .

[41]  XinQi Dong,et al.  Integrating cultural humility into health care professional education and training , 2010, Advances in Health Sciences Education.

[42]  A. Fenaughty,et al.  Correlates of Alaska Native fatal and nonfatal suicidal behaviors 1990-2001. , 2008, Suicide & life-threatening behavior.

[43]  R. Herzig,et al.  The interpretation of "culture": diverging perspectives on medical provision in rural Montana. , 2006, Social science & medicine.

[44]  Philip A. Fisher,et al.  Balancing empiricism and local cultural knowledge in the design of prevention research , 2005, Journal of Urban Health.

[45]  K. Krysińska Suicide postvention in the schools , 2003 .

[46]  J. Simoni,et al.  Reconceptualizing native women's health: an "indigenist" stress-coping model. , 2002, American journal of public health.

[47]  Linda Smith,et al.  Decolonizing Methodologies: Research and Indigenous Peoples , 2000 .