Project Summary

PCORI has identified suicide prevention among youth as an important research topic. Suicide rates in the United States have been increasing over the past two decades, and the COVID-19 pandemic may have led to further increases. Patients, caregivers, clinicians, and others want to learn: What are effective ways of preventing suicide among youth ages 15 to 24? To help answer this question, PCORI launched an initiative in 2020 on Suicide Prevention: Brief Interventions for Youth. The initiative funded this research project and others.

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Suicide is the leading cause of death among Alaska Native young people ages 15–24. Connecting young people who are at risk for suicide with treatment that meets their needs and with resources and that are located near where they live can help prevent self-harm.

In this study, the research team is comparing two ways to reduce the risk for suicide and other self-harm behaviors and improve mental health among Alaska Native young people:

  • Tools for Life. Tools for Life is a 45-minute program that helps young people identify their cultural protective factors. Such factors may include safe places, role models, and social connections that build young people’s sense of strength and purpose. The research team is adapting this program for Alaska Native young people by adding cultural content from a proven program called Qungasvik. In Qungasvik, community elders and cultural guides lead young people in activities to help them learn about their culture.  
  • Tools for Life plus Motivational Interviewing Social Network, or MISN. MISN is a 15-minute program that helps young people build confidence, get support from Alaska Native people in their communities, and make positive changes to their social networks.

Both programs are part of the Because We Love You, or BeWeL, study. This study helps at-risk Alaska Native young people get cultural services.

Who can this research help?

Results may help Alaska Native tribes and tribal health organizations address suicide risk among young people who live in rural or remote villages. They may also help hospital and clinic administrators in urban centers when considering ways to reduce risk for suicide and self-harm among Alaska Native young people.

What is the research team doing?

The research team is conducting the study in two tribal health regions in Alaska. The team is recruiting 370 Alaska Native young people ages 15–24 with mental health concerns who visit clinics. The team is assigning young people by chance to receive the culturally tailored Tools for Life program with or without MISN. A team of suicide prevention specialists and elders from the Alaska Native communities are leading both programs.

Two and six weeks after completing the programs, all young people in the study are attending two 15-minute virtual sessions. At the sessions, young people who received only Tools for Life talk about whether they have taken part in cultural activities since completing the program. Young people who received Tools for Life plus MISN talk about whether they have changed their social networks to obtain more support.

The research team is surveying youth at the start of the study and again 3, 6, and 12 months later. Surveys ask youth about their:

  • Thoughts of suicide
  • Mental health
  • Alcohol use
  • Sense of connection to Alaska Native culture
  • Social support
  • Reasons for living
  • Community protective factors

The research team is looking at differences in how well the programs work among young people based on their age, gender, severity of depression, and protective factors. The team is interviewing 40 young people about how satisfied they were with the programs.

Alaska Native community advisors and young people are helping to design and conduct this study.

Research methods at a glance

Design Element Description
Design Randomized controlled trial
Population 370 youth and young adults ages 15–24 who self-identify as Alaska Native and who have been admitted to the hospital for a suicide attempt, suicidal ideation, or associated risk behaviors including alcohol-related injury or acute intoxication
  • Tools for Life
  • Tools for Life plus MISN

Primary: suicide intent/risk, depression, anxiety, frequency of alcohol use, consequences of alcohol use

Secondary: sobriety self-efficacy, intentions to be sober from alcohol, social network composition, social network structure, time spent around peers who use alcohol, awareness of connectedness, community protective factors, individual protective factors, reasons for living

Timeframe Timeframe Length of follow-up for collecting data on primary outcomes. View Glossary Up to 1-year follow-up for primary outcomes

Project Information

Elizabeth D'Amico, PhD
Stacy Rasmus, PhD
RAND Corporation
Comparative Effectiveness of Two Culturally Centered Suicide Interventions for Alaska Native Youth

Key Dates

July 2021
June 2027

Study Registration Information


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: March 14, 2024