ABSTRACT At risk youth (ARY) are those who are at risk for suicide and self-harm. Suicide is the second highest cause of death among adolescents, but parent support and communication can improve mental health outcomes for this population. There are few formal support programs to help parents navigate conversations with their children about suicide and self-harm. This K23 project will: 1) survey a cross-section of parents of ARY in the United States to better understand their experiences, 2) design a stakeholder-informed online support intervention including peer support, and 3) pilot test the online support intervention for feasibility and acceptability. Conduct of these aims, in addition to a career development plan inclusive of coursework, workshops, and leadership development, will allow for the applicant’s academic growth in nationally representative surveys, stakeholder-engaged intervention development, clinical trials, and research program leadership, and will further advance the applicant’s transition to independence. These aims will also provide the necessary data to conduct a future R01 randomized control trial to evaluate the effectiveness of the stakeholder-designed intervention to improve parent confidence in supporting ARY. TITLE Development and Feasibility Trial of Online Peer Support for Parents of At Risk Youth MAJOR GOALS OF THE PROJECT Aim 1: Identify factors associated with supporting youth in a national sample of parents. Identifying parent factors associated with supporting youth is critical to design parent support interventions that are feasible and effective at increasing parent support and improving youth health. I will conduct an online, national, cross-sectional study of parents of ARY to identify factors associated with parent support. Aim 2: Develop a stakeholder-informed online support intervention for parents of ARY. Stakeholder input is vital for creating an acceptable support intervention to help parents support their children and improve health outcomes for ARY. Using a community engaged intervention mapping approach, I will continue to conduct semi-structured individual interviews of up to 40 parents to understand key stakeholder perspectives on the core features and design of an online parent support intervention. An iterative user-centered design process will be used to develop the intervention currently planned to consist of a 1:1 peer network. Aim 3: Assess feasibility and acceptability of the intervention with parents of ARY. Parents of ARY seek support and resources online and assessing feasibility and acceptability of an online support intervention for these parents is needed before further exploration of intervention effects. I will pilot the stakeholder-informed intervention in a randomized feasibility trial with parent-ARY youth dyads to assess their perspectives regarding its feasibility and acceptability compared to control dyads accessing an existing online information page for families ...