Abstract
Suicide is the second leading cause of death among American Indian and Alaska Native youth, and within the Alaska Native youth subpopulation, the leading cause of death. In response to this public health crisis, American Indian and Alaska Native communities have created strategies to protect their young people by building resilience using localized Indigenous well-being frameworks and cultural strengths. These approaches to suicide prevention emphasize promotion of protective factors over risk reduction. A measure of culturally based protective factors from suicide risk has potential to assess outcomes from these strengths-based, culturally grounded suicide prevention efforts, and can potentially address several substantive concerns regarding direct assessment of suicide risk. We report on the Reasons for Life (RFL) scale, a measure of protective factors from suicide, testing psychometric properties including internal structure with 302 rural Alaska Native Yup’ik youth. Confirmatory factor analyses revealed the RFL is best described through three distinct first-order factors organized under one higher second-order factor. Item response theory analyses identified 11 satisfactorily functioning items. The RFL correlates with other measures of more general protective factors. Implications of these findings are described, including generalizability to other American Indian and Alaska Native, other Indigenous, and other culturally distinct suicide disparities groups.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 709-723 |
| Number of pages | 15 |
| Journal | Assessment |
| Volume | 28 |
| Issue number | 3 |
| DOIs | |
| State | Published - Apr 2021 |
Bibliographical note
Funding Information:https://orcid.org/0000-0002-5567-6302 Allen James 1 Rasmus Stacy M. 2 Fok Carlotta Ching Ting 2 Charles Billy 2 Trimble Joseph 3 Lee KyungSook 4 and the Qungasvik Team 2 1 University of Minnesota Medical School, Duluth, MN, USA 2 University of Alaska Fairbanks, Fairbanks, AK, USA 3 Western Washington University, Bellingham, WA, USA 4 Michigan State University, East Lansing, MI, USA James Allen, Memory Keepers Medical Discovery Team–American Indian and Rural Health Equity, Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, 624 East 1st Street, Suite 201, Duluth, MN 55812-3301, USA. Email: jallen@umn.edu 9 2019 1073191119875789 © The Author(s) 2019 2019 SAGE Publications Suicide is the second leading cause of death among American Indian and Alaska Native youth, and within the Alaska Native youth subpopulation, the leading cause of death. In response to this public health crisis, American Indian and Alaska Native communities have created strategies to protect their young people by building resilience using localized Indigenous well-being frameworks and cultural strengths. These approaches to suicide prevention emphasize promotion of protective factors over risk reduction. A measure of culturally based protective factors from suicide risk has potential to assess outcomes from these strengths-based, culturally grounded suicide prevention efforts, and can potentially address several substantive concerns regarding direct assessment of suicide risk. We report on the Reasons for Life (RFL) scale, a measure of protective factors from suicide, testing psychometric properties including internal structure with 302 rural Alaska Native Yup’ik youth. Confirmatory factor analyses revealed the RFL is best described through three distinct first-order factors organized under one higher second-order factor. Item response theory analyses identified 11 satisfactorily functioning items. The RFL correlates with other measures of more general protective factors. Implications of these findings are described, including generalizability to other American Indian and Alaska Native, other Indigenous, and other culturally distinct suicide disparities groups. suicide prevention American Indian and Alaska Native suicide assessment protective factors suicide prevention outcomes assessment National Institute on Minority Health and Health Disparities https://doi.org/10.13039/100006545 R24MD001626 National Institute on Alcohol Abuse and Alcoholism https://doi.org/10.13039/100000027 R01AA023754 National Institute on Alcohol Abuse and Alcoholism https://doi.org/10.13039/100000027 R21AA015541 National Institute on Alcohol Abuse and Alcoholism https://doi.org/10.13039/100000027 R21AA016098 National Institute on Alcohol Abuse and Alcoholism https://doi.org/10.13039/100000027 RO1AA11446 National Institute of General Medical Sciences https://doi.org/10.13039/100000057 P20RR061430 National Institute of Mental Health https://doi.org/10.13039/100000025 RO1AA11446 (cofunder) National Institute of Mental Health https://doi.org/10.13039/100000025 U19MH113138 edited-state corrected-proof Authors’ Note The Qungasvik Team includes past members of the Yupiucimta Asvairtuumallerkaa Council, the Ellangneq Council, the Yuuyaraq Council, the Yup’ik Regional Coordinating Council, the Ellangneq Advisory Group, and the Ellangneq, Yupiucimta Asvairtuumallerkaa, and Cuqyun Project staff. The Yupiucimta Asvairtuumallerkaa Council included Sophie Agimuk, Harry Asuluk, Thomas Asuluk, T. J. Bentley, John Carl, Mary Carl, Emily Chagluk, James Charlie, Sr., Lizzie Chimiugak, Ruth Jimmie, Jolene John, Paul John, Simeon John, Aaron Moses, Phillip Moses, Harry Tulik, and Cecelia White. The Ellangneq Council included Catherine Agayar, Fred Augustine, Mary Augustine, Paula Ayunerak, Theresa Damian, Lawrence Edmund, Sr., Barbara Joe, Lucy Joseph, Joe Joseph, Placide Joseph, Zacheus Paul, Charlotte Phillip, Henry Phillip, Joe Phillip, Penny Alstrom, Shelby Edmund, Dennis Sheldon, Isidore Shelton, Freddie Edmund, Josie Edmund, and Flora Patrick. The Yuuyaraq Council included the elders Ben Tucker, Phillip Yupanik, Andrew Kelly, Matrona Yupanik, Mike Andrews, Sr., Maryann Andrews, Evan Hamilton, Jr., Nick Tucker, Paul Crane, Clara Andrews, Bernice Redfox, Margaret Charles, Cecilia Redfox, Ray Waska, Sr., Peter Moore, and Martin Moore, Sr., and community members Ronald Trader, Fredrick Joseph, Marvin Kelly, Stephen Levi, Leandra Andrews, Malora Hunt, Dominic Hunt, Patrick Tam, Yolanda Kelly, Emily Crane, Grace Charles, Roberta Murphy, Ray Waska, Jr., Doug Redfox, Evan Charles Mark Tucker, Greg Fratis, and Wilbur Hootch. The Yup’ik Regional Coordinating Council included Martha Simon, Moses Tulim, Ed Adams, Tammy Aguchak, Paula Ayunerak, Sebastian Cowboy, Lawrence Edmunds, Margaret Harpak, Charles Moses, and Raymond Oney. The Ellangneq Advisory Group included Walkie Charles, Richard Katz, Mary Sexton, Lisa Rey Thomas, Beti Thompson, and Edison Trickett. The current Qungasvik Team members are Billy Charles, Cyndi Nation, Simeon John, Jorene Joe, Jennifer Nu, Georgianna Ningelook, Pamela Aguchak, Mark Tucker, Vanessa Lincoln, Travis Isadore, Jorg Edmund, Dennis Sheldon, Sam Joe, and Dhara Shah. We report how we determined our sample size, all data exclusions, all manipulations, and all measures in the study. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded by National Institute of Alcohol Abuse and Alcoholism, National Institute for Minority Health and Health Disparities, National Institute of Mental Health, and National Institute of General Medical Sciences Grants R01AA11446, R21AA015541, R01AA023754, R21AA0016098, R24MD001626, R01AA023754, U19MH113138, and P20RR061430. ORCID iD James Allen https://orcid.org/0000-0002-5567-6302 Supplemental Material Supplemental material for this article is available online.
Publisher Copyright:
© The Author(s) 2019.
Keywords
- American Indian and Alaska Native
- protective factors
- suicide assessment
- suicide prevention
- suicide prevention outcomes assessment
