Psychosocial Factors Associated with Parental Self-Efficacy in Adolescent Suicide Prevention

PROPOSAL SUMMARY-ABSTRACT Adolescent suicide is a growing public health problem and a leading cause of death in the US. Rates of adolescent suicide and suicidal behavior have been on the rise for the last two decades increasing disproportionally among Black adolescents. Increasing rates of suicidal behaviors have also led to a surge in adolescent ED visits. Parents play a central role in suicide prevention efforts by protecting their children from self-harm and promoting their mental health following discharge from the ED for suicidal behavior (SB) when a child’s risk for recurrent SB is greatest. Parents’ needs in caring for suicidal adolescents are often not considered yet they hold primary responsibility for ensuring their child’s safety after ED discharge. Parental self-efficacy (PSE) is a parent’s belief in their ability to fulfill their parenting role effectively and is a powerful predictor of parenting competence and child well-being. In the context of this study, PSE to prevent SB is conceptualized as a parent’s perceived ability to support their child in crisis, keep them safe, and prevent future SB. This convergent mixed-methods study seeks to understand the psychosocial factors associated with SB prevention self-efficacy among parents caring for adolescents following an ED visit for SB by addressing the following specific aims: 1) Examine associations between parent-level psychosocial factors, adolescent suicide-related characteristics, and parents’ SB prevention self-efficacy, 2) Based on individual parent interviews, understand how psychosocial and contextual factors influence parents’ SB prevention self-efficacy with an emphasis on understanding potential differences in the experiences of Black parents; and 3) Integrating results from Aims 1 and 2, identify potential strategies for building parents’ SB prevention self- efficacy in caring for an adolescent following an ED visit for SB. The study will be guided by a parent advisory group and leverage the research infrastructure of a larger PCORI-funded adolescent suicide prevention study in the Johns Hopkins Hospital Pediatric ED. Aim 1 (quantitative) will use cross-sectional data (n=125; 60% Black/African American); Aim 2 (qualitative) will include individual interviews (sub-sample of parents n=20; 50% Black/African American). Correlations and multiple linear regression models will be used to test the quantitative data; a content analysis approach will be used to analyze the qualitative data. Data from Aims 1 and 2 will be integrated to compare parents’ qualitative descriptions and quantitative scores and assess for potential differences in parents’ SB prevention self-efficacy based on parent-level psychosocial factors, adolescent suicide-related characteristics, and between Black/African American and White parents. Results of this study will fill a clinical research gap with the future goal of developing interventions to bolster the protective role of parents in preventing adolescent SB. The proposed study addresses the NIMH’s Strategic Plan, Strategic Framework for Addressing Youth Mental Health Disparities, and recent calls to identify risk and protective factors for youth suicide and prevention.