Children’s Advocacy Centers (CACs) provide coordinated interagency responses to sexual abuse and other severe maltreatment.8–10,21,22 There are >950 CACs in the United States, covering 75% of counties and serving hundreds of thousands of children annually.7 Half of CACs serve mostly rural populations.23 In each CAC, a multidisciplinary team works together to conduct investigations and provide services after allegations of sexual abuse and other serious maltreatment.8–10,21,22 Team members include CAC staff (i.e., professionals employed by the CAC) and professionals employed by separate organizations in different systems (e.g., law enforcement, child welfare, mental health, advocacy).8 They have diverse expertise and vary in suicide prevention knowledge, comfort, and skill as well as power, authority, and access to resources. CAC teams are well-positioned to implement brief interventions24 and prevent suicide among youth served by CACs.6,25

CAC teams include professionals from multiple disciplines (e.g., law enforcement, victim advocacy, mental health, child welfare) with varied training and experience in suicide prevention.8–10 Effective collaboration among team members with diverse expertise could be leveraged to mitigate suicide risk in vulnerable rural youth served by CACs. The objectives of this proposal are to 1) describe suicide prevention efforts in rural CACs, 2) use social network methods to visualize and describe how team members collaborate in suicide prevention efforts, and 3) identify facilitators and barriers to suicide prevention in rural CACs.

Results from this pilot study will inform the development of interventions and implementation strategies that leverage social networks to support suicide prevention in rural CACs.

Suicide rates are on the rise, particularly among Black youth. Pediatric primary care is a natural front-line care setting to identify youth at risk for depression and suicide. The Children’s Hospital of Philadelphia (CHOP) serves a high proportion of families who identify as ethnic and/or racial minorities and has put in place routine screening for suicide and depression in primary care. Research suggests that a large proportion of youth have not spoken to their caregivers about their suicidality prior to these screenings, so they may be very surprised to learn about what their teen is going through at these visits. The understandable emotional response among caregivers may make it difficult for them to manage their teen’s crisis. Thus, we need to attend to the needs of caregivers to better prepare them to support their teens at this important time. Thus, the purpose of the study is to use qualitative methods to inform the design of a caregiver-facing intervention for caregivers of teens endorsing suicide risk on a depression screener administered during primary care well visits. Specifically, we hope to (a) identify intervention targets, as well as barriers and facilitators to intervention engagement and implementation from the perspectives of impacted community partners (parents, adolescents), and (b) synthesize partner feedback to create a low-fidelity mockup of a caregiver-facing intervention, which will be presented to ETUDES engagement group members (parents, providers, healthcare leaders) for further feedback, particularly with an eye towards sustainable implementation of the brief intervention in primary care.

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