SpringerLink
Log in

Protective Factors as a Unifying Framework for Strength-Based Intervention and Culturally Responsive American Indian and Alaska Native Suicide Prevention

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

The ongoing challenge of American Indian and Alaska Native (AIAN) youth suicide is a public health crisis of relatively recent historical origin inadequately addressed by contemporary prevention science. A promising development in AIAN suicide prevention highlights the role of protective factors. A protective factor framework adopts a social ecological perspective and community-level intervention paradigm. Emphasis on protection highlights strength-based AIAN cultural strategies in prevention of youth suicide. Attention to multiple intersecting levels incorporates strategies promoting community as well as individual resilience processes, seeking to influence larger contexts as well as individuals within them. This approach expands the scope of suicide prevention strategies beyond the individual level and tertiary prevention strategies. Interventions that focus on mechanisms of protection offer a rigorous, replicable, and complementary prevention science alternative to risk reduction approaches. This selected review critically examines recent AIAN protective factor suicide prevention science. One aim is to clarify key concepts including protection, resilience, and cultural continuity. A broader aim is to describe the evolution of this promising new framework for conducting primary research about AIAN suicide, and for designing and testing more effective intervention. Recommendations emphasize focus on mechanisms, multilevel interactions, more precise use of theory and terms, implications for new intervention development, alertness to unanticipated impacts, and culture as fundamental in a protective factors framework for AIAN suicide prevention. A protective factor framework holds significant potential for advancing AIAN suicide prevention and for work with other culturally distinct suicide disparity groups, with broad implications for other areas of prevention science.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Allen, J., Rasmus, S., Fok, C. C. T., Charles, B., Henry, D., & Qungasvik, T. (2018). Multi-level cultural intervention for the prevention of suicide and alcohol use risk with Alaska Native youth: A nonrandomized comparison of treatment intensity. Prevention Science, 19, 174–185. https://doi.org/10.1007/s11121-017-0798-9

    Article  PubMed  PubMed Central  Google Scholar 

  • Allen, J., Hopper, K., Wexler, L., Kral, M., Rasmus, S., & Nystad, K. (2014a). Map** resilience pathways of Indigenous youth in five circumpolar communities. Transcultural Psychiatry, 51), 601–631. https://doi.org/10.1177/1363461513497232

    Article  PubMed  Google Scholar 

  • Allen, J., Mohatt, G. V., Fok, C. C., Henry, D., Burkett, R., & People Awakening, T. (2014b). A protective factors model for alcohol abuse and suicide prevention among Alaska Native youth. American Journal of Community Psychology, 54, 125–139. https://doi.org/10.1007/s10464-014-9661-3

    Article  Google Scholar 

  • Appadurai, A. (2004). The capacity to aspire: Culture and the terms of recognition. In V. Rao, & M. Walton (Eds.), Culture and public action. Palo Alto, CA: Stanford University Press

  • Auger, M. D. (2016). Cultural continuity as a determinant of Indigenous peoples’ health: A metasynthesis of qualitative research in Canada and the United States. International Indigenous Policy Journal, 7, 1–24. https://doi.org/10.18584/iipj.2016.7.4.3

    Article  Google Scholar 

  • Bandura, A. (1986). The explanatory and predictive scope of self-efficacy theory. Journal of Social and Clinical Psychology, 4, 359–373. https://doi.org/10.1521/jscp.1986.4.3.359

    Article  Google Scholar 

  • Beaudoin, V., Séguin, M., Chawky, N., Affleck, W., Chachamovich, E., & Turecki, G. (2018). Protective factors in the Inuit population of Nunavut: A comparative study of people who died by suicide, people who attempted suicide, and people who never attempted suicide. International Journal of Environmental Research and Public Health, 15, 144.

    Article  Google Scholar 

  • Beckett, C., Maughan, B., Rutter, M., Castle, J., Colvert, E., Groothues, C., et al. (2006). Do the effects of early severe deprivation on cognition persist into early adolescence? Findings from the English and Romanian adoptees study. Child Development, 77, 696–711. https://doi.org/10.1111/j.1467-8624.2006.00898.x

    Article  PubMed  Google Scholar 

  • Borowsky, I. W., Resnick, M. D., Ireland, M., & Blum, R. W. (1999). Suicide attempts among American Indian and Alaska Native youth: Risk and protective factors. Archives of Pediatrics and Adolescent Medicine, 153, 573–580. https://doi.org/10.1001/archpedi.153.6.573

    Article  CAS  PubMed  Google Scholar 

  • Brave Heart, M. Y. H., Chase, J., Elkins, J., & Altschul, D. B. (2011). Historical trauma among Indigenous peoples of the Americas: Concepts, research, and clinical considerations. Journal of Psychoactive Drugs, 43, 282–290. https://doi.org/10.1080/02791072.2011.628913

    Article  Google Scholar 

  • Breuer, E., Lee, L., De Silva, M., & Lund, C. (2016). Using theory of change to design and evaluate public health interventions: A systematic review. Implementation Science, 11, 63. https://doi.org/10.1186/s13012-016-0422-6

    Article  PubMed  PubMed Central  Google Scholar 

  • Carolissen, R., Duckett, P., Sonn, C., Allen, N. E., Trout, L., McEachern, D., Mullany, A., White, L., Wexler, L. (2018). Decoloniality as a Framework for Indigenous Youth Suicide Prevention Pedagogy: Promoting Community Conversations About Research to End Suicide. American Journal of Community Psychology, 62, 396-405

  • Chandler, M. J., & Lalonde, C. E. (1998). Cultural continuity as a hedge against suicide in Canada’s First Nations. Transcultural Psychiatry, 35, 191–219.

    Article  Google Scholar 

  • Chandler, M. J., & Lalonde, C. E. (2008). Cultural continuity as a moderator of suicide risk among Canada’s First Nations. In L. J. Kirmayer, & G. Valakakis (Eds.), Healing traditions: The mental health background of Aboriginal peoples in Canada (pp. 221–248): University of British Columbia Press

  • Chandler, M. J., Lalonde, C. E., Sokol, B. W., & Hallett, D. (2003). Personal persistence, identity development, and suicide: A study of Native and Non-native North American adolescents. Monogr Soc Res Child Dev, 68, vii-viii, 1–130; discussion 131–138, https://doi.org/10.1111/1540-5834.00246

  • Chandler, M. J., & Proulx, T. (2006). Changing selves in changing worlds: Youth suicide on the fault-lines of colliding cultures. Archives of Suicide Research, 10, 125–140. https://doi.org/10.1080/13811110600556707

    Article  PubMed  Google Scholar 

  • Chang, B. P., Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., et al. (2016). Biological risk factors for suicidal behaviors: A meta-analysis. Translational Psychiatry, 6, e887. https://doi.org/10.1038/tp.2016.165

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Chapin, F. S., Matson, P. A., & Vitousek, P. M. (2011). Principles of Terrestrial Ecosystem Ecology. Springer.

    Book  Google Scholar 

  • Chu, C., Buchman-Schmitt, J. M., Stanley, I. H., Hom, M. A., Tucker, R. P., Hagan, C. R., et al. (2017). The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychological Bulletin, 143, 1313–1345. https://doi.org/10.1037/bul0000123

    Article  PubMed  PubMed Central  Google Scholar 

  • Chu, J., Maruyama, B., Batchelder, H., Goldblum, P., Bongar, B., & Wickham, R. E. (2020). Cultural pathways for suicidal ideation and behaviors. Cultural Diversity & Ethnic Minority Psychology, 26, 367–377. https://doi.org/10.1037/cdp0000307

    Article  Google Scholar 

  • Cicchetti, D., & Lynch, M. (1993). Toward an ecological/transactional model of community violence and child maltreatment: Consequences for children’s development. Psychiatry, 56, 96–118. https://doi.org/10.1080/00332747.1993.11024624

    Article  CAS  PubMed  Google Scholar 

  • Currie, C. L., Copeland, J. L., & Metz, G. A. (2019). Childhood racial discrimination and adult allostatic load: The role of Indigenous cultural continuity in allostatic resiliency. Social Science and Medicine, 241, 112564. https://doi.org/10.1016/j.socscimed.2019.112564

    Article  PubMed  Google Scholar 

  • Cwik, M. F., Barlow, A., Goklish, N., Larzelere-Hinton, F., Tingey, L., Craig, M., et al. (2014). Community-based surveillance and case management for suicide prevention: An American Indian tribally initiated system. American Journal of Public Health, 104, e18-23. https://doi.org/10.2105/AJPH.2014.301872

    Article  PubMed  PubMed Central  Google Scholar 

  • Cwik, M., Goklish, N., Masten, K., Lee, A., Suttle, R., Alchesay, M., et al. (2019). “Let our Apache heritage and culture live on forever and teach the young ones”: Development of the Elders’ Resilience Curriculum, an upstream suicide prevention approach for American Indian youth. American Journal of Community Psychology, 64, 137–145. https://doi.org/10.1002/ajcp.12351

    Article  PubMed  Google Scholar 

  • Cwik, M., Tingey, L., Maschino, A., Goklish, N., Larzelere-Hinton, F., Walkup, J., et al. (2016). Decreases in suicide deaths and attempts linked to the White Mountain Apache Suicide Surveillance and Prevention System, 2001–2012. American Journal of Public Health, 106, 2183–2189. https://doi.org/10.2105/AJPH.2016.303453

    Article  PubMed  PubMed Central  Google Scholar 

  • Deloria, V. (1979). The metaphysics of modern existence. Harper & Row.

    Google Scholar 

  • Department of Health and Human Services (DHHS) (2012a). Appendix C, Brief history of suicide prevention in the United States. In National strategy for suicide prevention: goals and objectives for action: A report of the U.S. Surgeon General and of the National Action Alliance for Suicide Prevention. Washington, DC: US Department of Health & Human Services

  • Department of Health and Human Services (DHHS) (2012b). Appendix D, Groups with increased suicide risk. In National strategy for suicide prevention: Goals and objectives for action: A report of the U.S. Surgeon General and of the National Action Alliance for Suicide Prevention. Washington, DC: US Department of Health & Human Services

  • Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., et al. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143, 187–232. https://doi.org/10.1037/bul0000084

    Article  PubMed  Google Scholar 

  • Garrett, M. W. (1995). Between two worlds: Cultural discontinuity in the dropout of Native American youth. The School Counselor, 42, 186–195.

    Google Scholar 

  • Gottfredson, D. C., Cook, T. D., Gardner, F. E., Gorman-Smith, D., Howe, G. W., Sandler, I. N., et al. (2015). Standards of evidence for efficacy, effectiveness, and scale-up research in prevention science: Next generation. Prevention Science, 16, 893–926. https://doi.org/10.1007/s11121-015-0555-x

    Article  PubMed  PubMed Central  Google Scholar 

  • Hall, G. C., Yip, T., & Zarate, M. A. (2016). On becoming multicultural in a monocultural research world: A conceptual approach to studying ethnocultural diversity. American Psychologist, 71, 40–51. https://doi.org/10.1037/a0039734

    Article  Google Scholar 

  • Hallett, D., Chandler, M. J., & Lalonde, C. E. (2007). Aboriginal language knowledge and youth suicide. Cognitive Development, 22, 392–399. https://doi.org/10.1016/j.cogdev.2007.02.001

    Article  Google Scholar 

  • Hatala, A. R., Pearl, T., Bird-Naytowhow, K., Judge, A., Sjoblom, E., & Liebenberg, L. (2017). “I have strong hopes for the future”: Time orientations and resilience among Canadian indigenous youth. Qualitative Health Research, 27, 1330–1344.

    Article  Google Scholar 

  • Hawkins, E. H., Cummins, L. H., & Marlatt, G. A. (2004). Preventing substance abuse in American Indian and Alaska Native youth: Promising strategies for healthier communities. Psychological Bulletin, 130, 304–323. https://doi.org/10.1037/0033-2909.130.2.304

    Article  PubMed  Google Scholar 

  • Hedegaard, H., Curtin, S., & Warner, M. (2018). Suicide mortality in the United States, 1999–2017. (Vol. NCHS Data Brief, no 330). Hyattsville, MD: National Center for Health Statistics

  • Henson, M., Sabo, S., Trujillo, A., & Teufel-Shone, N. (2017). Identifying protective factors to promote health in American Indian and Alaska Native adolescents: A literature review. The Journal of Primary Prevention, 38, 5–26. https://doi.org/10.1007/s10935-016-0455-2

    Article  PubMed  PubMed Central  Google Scholar 

  • Jongen, C. S., McCalman, J., & Bainbridge, R. G. (2019). A systematic sco** review of the resilience intervention literature for Indigenous adolescents in CANZUS Nations. Frontiers in Public Health, 7, 351. https://doi.org/10.3389/fpubh.2019.00351

    Article  PubMed  Google Scholar 

  • Kirmayer, L. J., Dandeneau, S., Marshall, E., Phillips, M. K., & Williamson, K. J. (2011). Rethinking resilience from Indigenous perspectives. Canadian Journal of Psychiatry, 56, 84–91. https://doi.org/10.1177/070674371105600203

    Article  PubMed  Google Scholar 

  • Kirmayer, L. J., Gone, J. P., & Moses, J. (2014). Rethinking historical trauma. Transcultural Psychiatry, 51, 299–319. https://doi.org/10.1177/1363461514536358

    Article  PubMed  Google Scholar 

  • Kirmayer, L. J., Sehdev, M. , Whitley, R., Dandeneau, S. F., & Isaac, C. (2009). Community resilience: Models, metaphors and measures. Journal of Aboriginal Health, November, 62–117

  • Ladner, K. L. (2009). Understanding the impact of self-determination on communities in crisis. Journal of Aboriginal Health, 5, 88–101.

    Google Scholar 

  • Lafrance, J., Bodor, R., & Bastien, B. (2008). Synchronicity or serendipity? Aboriginal wisdom and childhood resilience. In L. Liebenbert, & M. Ungar (Eds.), Resilience in Action (pp. 289–320). Toronto University of Toronto Press.

  • Lee, H. W., Melson, M., Ivanich, J., Habecker, P., Gauthier, G. R., Wexler, L., Khan, B., Dombrowski, K., Bianconi, G. (2018). Map** the structure of perceptions in hel** networks of Alaska Natives. Plos One, 13, e0204343

  • Loeber, R., & Farrington, D. P. (2012). Advancing knowledge about direct protective factors that may reduce youth violence. American Journal of Preventive Medicine, 43, S24-27. https://doi.org/10.1016/j.amepre.2012.04.031

    Article  PubMed  Google Scholar 

  • Lösel, F., & Farrington, D. P. (2012). Direct protective and buffering protective factors in the development of youth violence. American Journal of Preventive Medicine, 43, S8-s23. https://doi.org/10.1016/j.amepre.2012.04.029

    Article  PubMed  Google Scholar 

  • Luthar, S. S., & Cicchetti, D. (2000). The construct of resilience: Implications for interventions and social policies. Development and Psychopathology, 12, 857–885. https://doi.org/10.1017/s0954579400004156

    Article  PubMed Central  Google Scholar 

  • Manson, S. M. (2020). The role of culture in effective intervention design, implementation, and research: Its universal importance. Prevention Science, 21, 93–97. https://doi.org/10.1007/s11121-019-01065-7

    Article  PubMed  PubMed Central  Google Scholar 

  • Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and Psychopathology, 2, 425–444. https://doi.org/10.1017/S0954579400005812

    Article  Google Scholar 

  • Masten, A. S., & Motti-Stefanidi, F. (2020). Multisystem resilience for children and youth in disaster: Reflections in the context of COVID-19. Advers. Resil. Sci., 1, 95–106. https://doi.org/10.1007/s42844-020-00010-w

    Article  Google Scholar 

  • Mohatt, G. V., Fok, C. C. T., Henry, D., People Awakening Team, & Allen, J. (2014). Feasibility of a community intervention for the prevention of suicide and alcohol abuse with Yup’ik Alaska Native youth: The Elluam Tungiinun and Yupiucimta Asvairtuumallerkaa studies. American Journal of Community Psychology, 54(1–2), 153–169. https://doi.org/10.1007/s10464-014-9646-2

    Article  Google Scholar 

  • Mohatt, N. V., Thompson, A. B., Thai, N. D., & Tebes, J. K. (2014). Historical trauma as public narrative: A conceptual review of how history impacts present-day health. Social Science and Medicine, 106, 128–136. https://doi.org/10.1016/j.socscimed.2014.01.043

    Article  PubMed  Google Scholar 

  • NIMH Committee on Prevention Research (1995). A plan for prevention research for the National Institute of Mental Health. Washington, DC.

  • O’Keefe, V. M., Tucker, R. P., Cole, A. B., Hollingsworth, D. W., & Wingate, L. R. (2018). Understanding Indigenous suicide through a theoretical lens: A review of general, culturally-based, and Indigenous frameworks. Transcultural Psychiatry, 55, 775–799. https://doi.org/10.1177/1363461518778937

    Article  PubMed  Google Scholar 

  • Oster, R. T., Grier, A., Lightning, R., Mayan, M. J., & Toth, E. L. (2014). Cultural continuity, traditional Indigenous language, and diabetes in Alberta First Nations: A mixed methods study. Int J Equity Health, 13, 92. https://doi.org/10.1186/s12939-014-0092-4

    Article  PubMed  PubMed Central  Google Scholar 

  • Polkinghorne, C. (1988). Narrative knowing and the human sciences. SUNY Press.

    Google Scholar 

  • Rasmus, S. M., Allen, J., & Ford, T. (2014a). “Where I have to learn the ways how to live:” Youth resilience in a Yup’ik village in Alaska. Transcultural Psychiatry, 51, 713–734. https://doi.org/10.1177/1363461514532512

    Article  PubMed  PubMed Central  Google Scholar 

  • Rasmus, S. M., Charles, B., & Mohatt, G. V. (2014b). Creating Qungasvik (a Yup’ik intervention “toolbox”): Case examples from a community-developed and culturally-driven intervention. American Journal of Community Psychology, 54, 140–152. https://doi.org/10.1007/s10464-014-9651-5

    Article  PubMed  PubMed Central  Google Scholar 

  • Rasmus, S. M., Trickett, E., Charles, B., John, S., & Allen, J. (2019). The Qasgiq model as an Indigenous intervention: Using the cultural logic of contexts to build protective factors for Alaska Native suicide and alcohol misuse prevention. Cultural Diversity & Ethnic Minority Psychology, 25, 44–54. https://doi.org/10.1037/cdp0000243

    Article  Google Scholar 

  • Ribeiro, J. D., Franklin, J. C., Fox, K. R., Bentley, K. H., Kleiman, E. M., Chang, B. P., et al. (2016). Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: A meta-analysis of longitudinal studies. Psychological Medicine, 46, 225–236. https://doi.org/10.1017/S0033291715001804

    Article  CAS  PubMed  Google Scholar 

  • Rowhani, M., & Hatala, A. (2017). A systematic review of resilience research among Indigenous youth in contemporary Canadian contexts. The International Journal of Health, Wellness, and Society, 7, 45–58. https://doi.org/10.18848/2156-8960/CGP/v07i04/

    Article  Google Scholar 

  • Rutter, M. (1985). Resilience in the face of adversity: Protective factors and resistance to psychiatric disorder. British Journal of Psychiatry, 147, 598–611. https://doi.org/10.1192/bjp.147.6.598

    Article  CAS  Google Scholar 

  • Sedikides, C., Wildschut, T., & Grouzet, F. (2018). On the temporal navigation of selfhood: The role of self-continuity. Self and Identity, 17, 255–258. https://doi.org/10.1080/15298868.2017.1391115

    Article  Google Scholar 

  • Sroufe, L. A., Egeland, B., Carlson, E. A., & Collins, W. A. (2005). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. Guilford Press.

    Google Scholar 

  • Tran, U. S., Huang, X., Ribeiro, J. D., Musacchio, K. M., & Franklin, J. C. (2017). Demographics as predictors of suicidal thoughts and behaviors: A meta-analysis. PLoS One, 12, e0180793. https://doi.org/10.1371/journal.pone.0180793

    Article  CAS  Google Scholar 

  • Trickett, E. J., Beehler, S., Deutsch, C., Green, L. W., Hawe, P., McLeroy, K., et al. (2011). Advancing the science of community-level interventions. American Journal of Public Health, 101, 1410–1419. https://doi.org/10.2105/AJPH.2010.300113

    Article  PubMed  PubMed Central  Google Scholar 

  • Trout, L., Wexler, L., & Moses, J. (2018). Beyond two worlds: Identity narratives and the aspirational futures of Alaska Native youth. Transcultural Psychiatry, 55, 800–820.

    Article  Google Scholar 

  • Ungar, M. (2011). The social ecology of resilience: Addressing contextual and cultural ambiguity of a nascent construct. Am J of Orthopsychiatry, 81, 1–17. https://doi.org/10.1111/j.1939-0025.2010.01067.x

    Article  Google Scholar 

  • Vanyukov, M. M., Tarter, R. E., Conway, K. P., Kirillova, G. P., Chandler, R. K., & Daley, D. C. (2016). Risk and resistance perspectives in translation-oriented etiology research. Transl Behav Med, 6, 44–54. https://doi.org/10.1007/s13142-015-0355-7

    Article  PubMed  Google Scholar 

  • Waldman, S. A., Kraft, W. K., Nelson, T. J., & Terzic, A. (2009). Experimental therapeutics: A paradigm for personalized medicine. Clinical and Translational Science, 2, 436–438. https://doi.org/10.1111/j.1752-8062.2009.00146.x

    Article  PubMed  PubMed Central  Google Scholar 

  • Waller, M. A. (2001). Resilience in ecosystemic context: Evolution of the concept. American Journal of Orthopsychiatry, 71, 290–297. https://doi.org/10.1037/0002-9432.71.3.290

    Article  CAS  Google Scholar 

  • Wexler, L., Chandler, M., Gone, J. P., Cwik, M., Kirmayer, L. J., LaFromboise, T., et al. (2015). Advancing suicide prevention research with rural American Indian and Alaska Native populations. American Journal of Public Health, 105, 891–899. https://doi.org/10.2105/AJPH.2014.302517

    Article  PubMed  PubMed Central  Google Scholar 

  • Wexler, L., DiFluvio, G., & Burke, T. K. (2009). Resilience and marginalized youth: Making a case for personal and collective meaning-making as part of resilience research in public health. Social Science and Medicine, 69, 565–570. https://doi.org/10.1016/j.socscimed.2009.06.022

    Article  PubMed  Google Scholar 

  • Wexler, L. M., & Gone, J. P. (2012). Culturally responsive suicide prevention in indigenous communities: Unexamined assumptions and new possibilities. American Journal of Public Health, 102, 800–806. https://doi.org/10.2105/AJPH.2011.300432

    Article  PubMed  PubMed Central  Google Scholar 

  • Wexler, L., Rataj, S., Plavin, J., Ivanich, J., Johnson, R., & Dombrowski, K. (2019). Community mobilization for rural suicide prevention: Perceived knowledge, skills, attitudes and behavioral outcomes from promoting community conversations about research to end suicide (PC CARES) in Northwest Alaska. Social Science and Medicine, 232, 398–407.

    Article  Google Scholar 

  • Wexler, L., Trout, L., Rataj, S., Kirk, T., Moto, R., McEachern, D. (2017). 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. International Journal of Circumpolar Health, 76, 1345277

  • Yoder, K. A., Whitbeck, L. B., Hoyt, D. R., & LaFromboise, T. (2006). Suicidal ideation among American Indian youths. Archives of Suicide Research, 10, 177–190. https://doi.org/10.1080/13811110600558240

    Article  PubMed  Google Scholar 

Download references

Funding

Preparation of this article was funded by the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Mental Health, and the National Institute for Minority Health and Health Disparities (U19MH113138, R01AA023754).

Author information

Authors and Affiliations

  1. Department of Family Medicine and Biobehavioral Health and Memory Keepers Medical Discovery Team–American Indian and Rural Health Equity, University of Minnesota Medical School, Duluth Campus, Duluth, MN, 55812, USA

    James Allen

  2. Department of Social Work and Research Center for Group Dynamics, Institute for Social Research, Univeristy of Michigan, Ann Arbor, MI, 48104, USA

    Lisa Wexler

  3. Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, 99775, USA

    Stacy Rasmus

Authors
  1. James Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa Wexler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stacy Rasmus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James Allen.

Ethics declarations

Ethics Approval

The article reports no human subject research. Funded projects supporting development of this article were approved by local tribal governments, Maniilaq Association, Norton Sound Health Corporation, Yukon Kuskokwim Health Corporation Human Studies Committee, Alaska Area IRB, University of Michigan IRB, and University of Alaska Fairbanks IRB. Procedures used in these projects adhere to the tenets of the Declaration of Helsinki.

Conflict of Interest

The authors declare no competing interests.

Consent to Participate

Because this is a review article, informed consent is not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Allen, J., Wexler, L. & Rasmus, S. Protective Factors as a Unifying Framework for Strength-Based Intervention and Culturally Responsive American Indian and Alaska Native Suicide Prevention. Prev Sci 23, 59–72 (2022). https://doi.org/10.1007/s11121-021-01265-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-021-01265-0

Keywords

Search

Navigation