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Principal Investigator: Gulchekhra Pirova
Organization: UNIVERSITY OF ILLINOIS AT CHICAGO
Fiscal Year: 2024
Award: $227,031
Funding agency: National Institute of Mental Health
Abstract
This R34 application responds to RFA-MH-23-260 by adapting and piloting a novel intervention for suicide
prevention in primary care for women at moderate or high risk for suicide in a low- and middle income
countries. 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, partnership, and equity of SUSTAIN to inform a future hybrid type 2
effectiveness-implementation pragmatic trial. The project will also build knowledge, skills, and capacities that
will inform future research on testing and implementation of multi-level approaches to suicide prevention which
can be part of an emerging national strategy in Tajikistan.
Terms: <21+ years old><Address><Adult><Adult Human><Asia><Assess implementation><Award><Behavior Conditioning Therapy><Behavior Modification><Behavior Therapy><Behavior Treatment><Behavioral Conditioning Therapy><Behavioral Modification><Behavioral Therapy><Behavioral Treatment><Care given by nurses><Caring><Cause of Death><Central Asia><Chicago><Collaborations><Communities><Conditioning Therapy><Country><Decrease health disparities><Education><Educational aspects><Effectiveness><Epidemic><Equity><Evaluation><Family Practice><Feeling suicidal><Fostering><Funding><Future><Goals><Health><Health Care Systems><Health disparity mitigation><Health disparity reduction><Healthcare Systems><Human Resources><Hybrids><Illinois><Implementation assessment><Individual><Institution><Intervention><Intervention Strategies><Investigation><Investigators><Knowledge><LMIC><Labor Migrations><Lower health disparities><Manpower><Mediator><Mental Health><Mental Health Services><Mental Hygiene><Mental Hygiene Services><Mental disorders><Mental health disorders><Mentorship><Methods><Mitigate health disparities><Modeling><NIH><NIMH><National Institute of Mental Health><National Institutes of Health><Nurses><Nursing Care><Outcome><Persons><Play><Policies><Prevention><Prevention program><Primary Care><Primary Health Care><Primary Healthcare><Process><Provider><Psychiatric Disease><Psychiatric Disorder><Psychological Health><Public Health Service><Randomized><Reduce health disparities><Research><Research Activity><Research Personnel><Research Support><Researchers><Risk Factors><Role><Rural><Strategic Planning><Suicidal thoughts><Suicide><Suicide attempt><Suicide precaution><Suicide prevention><Tajikistan><Testing><Training><USPHS><Unemployment><United States National Institutes of Health><United States Public Health Service><Universities><War><Woman><Womans Health Services><Women's Health Services><Womens Health Services><Work><adulthood><age group><behavior intervention><behavioral intervention><care as usual><cost><design><designing><evaluate implementation><evaluation of implementation><evidence base><exposure to violence><family medicine><fatal attempt><fatal suicide><female prevention><health goals><high risk><implementation evaluation><implementation outcomes><implementation process><implementation science><implementation/effectiveness><intent to die><interventional strategy><jobless><joblessness><longitudinal design><low and middle-income countries><men><mental health care><mental healthcare><mental illness><migration><non fatal attempt><nonfatal attempt><novel><nurse><out of work><peer><personnel><pilot test><pragmatic effectiveness trial><pragmatic trial><prevent in females><prevent in women><prevent suicidality><prevent suicide><prevention among females><prevention among women><prevention in females><prevention in women><primary care clinic><prisma><programs><protective factors><psychiatric illness><psychological disorder><randomisation><randomization><randomly assigned><reduce suicidality><reduce suicide><reducing suicidality><reducing suicide><scale up><skills><social role><socio-economic><socio-economically><socioeconomically><socioeconomics><suicidal attempt><suicidal behavior><suicidal ideation><suicidal risk><suicidal thinking><suicidality prevention><suicide behavior><suicide ideation><suicide intervention><suicide rate><suicide risk><suicides><thoughts about suicide><treatment as usual><unemployed><usual care><violence exposure><women's prevention>