# Improving screening and follow-up for suicidal ideation and behaviors among Latinx youth in primary care

> **NIH NIH R34** · JOHNS HOPKINS UNIVERSITY · 2024 · $152,132

## Abstract

Project Summary/Abstract
The objective of this proposal is to develop and pilot a systems-level strategy in pediatric
primary care to enhance identification and management of suicidal ideation and behavior in
Latinx youth, particularly those in immigrant families with parents who have limited English
proficiency (LEP). We will focus on the use of trained community health workers (CHWs) to
increase clinic capacity and quality of suicide risk screening and early intervention, with a focus
on safety planning, parent psychoeducation and care coordination. Our specific aims are 1: To
develop site-specific implementation protocols for the integration of CHWs into SIB screening
and safety planning for Latinx youth and their families; 2: To pilot the implementation of the
program in a six-month open trial in four pediatric primary care practices representing a range of
usual practice settings; and 3: To engage a stakeholder network to explore barriers and
facilitators, including costs and billing strategies, to implementation of this approach across a
broad range of pediatric primary care settings. In Aim 1, we will use Implementation Mapping, a
systematic process incorporating the perspectives of users (e.g., families), implementers (e.g.,
clinic staff), adopters (e.g. clinic administrators) and sustainers (e.g. healthcare service delivery
experts and payors) to guide development of strategies to adopt, implement and maintain an
evidence-based intervention in the four participating pediatric practices. In Aim 2, we will assess
feasibility, acceptability, and impact on organizational (e.g., increase in screening and CHW
referral, engagement in follow-up mental health visits) and patient-level outcomes (e.g.,
improved family functioning, parenting self-efficacy). Quantitative data (e.g., changes in rates of
screening) will be examined using an interrupted time series analysis. In Aim 3, we will conduct
semi-structured interviews with stakeholders and convene the stakeholder network to develop
an implementation plan for a larger trial. We will then integrate pilot trial and qualitative data
using mixed methods analysis to assess feasibility and acceptability at the organizational,
provider, and patient levels and convene to develop an implementation plan for a larger trial.
Successful completion of this deployment-focused pilot study would prepare us for
a future multi-site cluster randomized controlled trial assessing the effectiveness of the
implementation of suicide prevention interventions delivered by CHWs in health care settings on
rates of suicidal ideation and behavior for Latinx youth in pediatric primary care, with the long-
term goal of addressing mental health service disparities and preventing youth suicide.

## Key facts

- **NIH application ID:** 10813094
- **Project number:** 5R34MH129771-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Kiara Alvarez
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $152,132
- **Award type:** 5
- **Project period:** 2022-04-12 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10813094

## Citation

> US National Institutes of Health, RePORTER application 10813094, Improving screening and follow-up for suicidal ideation and behaviors among Latinx youth in primary care (5R34MH129771-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10813094. Licensed CC0.

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