Mary Cwik
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View article: Planning for the sustainability of a youth suicide prevention program in Native American contexts: A modeling study
Planning for the sustainability of a youth suicide prevention program in Native American contexts: A modeling study Open
We collaboratively developed a simulation model that assessed the relative impact of stakeholders' prioritized sustainment strategies. A multifaceted intervention for enhanced program management had the greatest impact on program sustainme…
View article: Protecting Native Families from COVID-19: Implementation and Lessons Learned from a Community-Based Approach to Collecting Evidence to Support Uptake of Health Behaviors During the COVID-19 Pandemic
Protecting Native Families from COVID-19: Implementation and Lessons Learned from a Community-Based Approach to Collecting Evidence to Support Uptake of Health Behaviors During the COVID-19 Pandemic Open
The COVID-19 pandemic highlighted longstanding health inequities, particularly among American Indian/Alaska Native (AIAN) communities, which experienced disproportionately high morbidity and mortality. This manuscript documents the impleme…
View article: Planning for the sustainability of a youth suicide prevention program in Native American contexts: A modeling study
Planning for the sustainability of a youth suicide prevention program in Native American contexts: A modeling study Open
Purpose: We aimed to identify actionable, effective sustainment strategies for a community-based suicide prevention program implemented in Tribal contexts through a participatory process of system dynamics modeling.Methods: Through a serie…
View article: Facilitators and Barriers to Implementing a Community Suicide Database and Prevention Program in Diverse Tribal Communities
Facilitators and Barriers to Implementing a Community Suicide Database and Prevention Program in Diverse Tribal Communities Open
Suicide is the second leading cause of death for American Indian youth, far surpassing the rates of suicide experienced by other races. The White Mountain Apache Tribe has made significant impacts on suicide risk by implementing a robust s…
View article: Factors Influencing Behaviors to Reduce the Spread of COVID-19 Among Indigenous Families in the Southwest, United States
Factors Influencing Behaviors to Reduce the Spread of COVID-19 Among Indigenous Families in the Southwest, United States Open
Indigenous communities in the United States (U.S.) have been disproportionately impacted by COVID-19, yet they have led efforts to combat the pandemic by providing local solutions that minimize viral transmission and promote vaccine uptake…
View article: Centering Community Strengths and Resisting Structural Racism to Prevent Youth Suicide: Learning from American Indian and Alaska Native Communities
Centering Community Strengths and Resisting Structural Racism to Prevent Youth Suicide: Learning from American Indian and Alaska Native Communities Open
The persistence of extreme suicide disparities in American Indian and Alaska Native (AI/AN) youth signals a severe health inequity with distinct associations to a colonial experience of historical and on-going cultural, social, economic, a…
View article: Demographic predictors of emergency service utilization patterns in youth at risk of suicide
Demographic predictors of emergency service utilization patterns in youth at risk of suicide Open
Objective To explore demographic predictors of Emergency Department (ED) utilization among youth with a history of suicidality (i.e., ideation or behaviors). Methods Electronic health records were extracted from 2017 to 2021 for 3094 8–22 …
View article: Evaluation of the Risk Identification for Suicide and Enhanced Care Model in a Native American Community
Evaluation of the Risk Identification for Suicide and Enhanced Care Model in a Native American Community Open
Importance There are many prognostic models of suicide risk, but few have been prospectively evaluated, and none has been developed specifically for Native American populations. Objective To prospectively validate a statistical risk model …
View article: Assessment of Selective and Universal Screening for Suicide Risk in a Pediatric Emergency Department
Assessment of Selective and Universal Screening for Suicide Risk in a Pediatric Emergency Department Open
Positive results of both selective and universal screening for suicide risk in pediatric EDs appear to be associated with subsequent suicidal behavior. Screening may be a particularly effective way to detect suicide risk among those who di…
View article: New Collaborative Research on Suicide Prevention, Practice, and Policy With American Indian and Alaska Native Communities Holds Promise for All Peoples
New Collaborative Research on Suicide Prevention, Practice, and Policy With American Indian and Alaska Native Communities Holds Promise for All Peoples Open
Youth suicide is increasing in the United States, with deaths among younger people of color driving this upward trend. For more than four decades, American Indian and Alaska Native (AIAN) communities have suffered disproportionate rates of…
View article: Prediction of Suicide Attempts and Suicide-Related Events Among Adolescents Seen in Emergency Departments
Prediction of Suicide Attempts and Suicide-Related Events Among Adolescents Seen in Emergency Departments Open
Importance Screening adolescents in emergency departments (EDs) for suicidal risk is a recommended strategy for suicide prevention. Comparing screening measures on predictive validity could guide ED clinicians in choosing a screening tool.…
View article: Planning for implementation and sustainability of a community-based suicide surveillance system in a Native American community
Planning for implementation and sustainability of a community-based suicide surveillance system in a Native American community Open
Background Native American youth, primarily living on reservations, suffer the highest burden of suicide of any racial group in the USA. Implementation and sustainability of culturally grounded, evidence-based interventions are needed to a…
View article: Demographic Predictors of Emergency Service Utilization Patterns in Youth At Risk of Suicide
Demographic Predictors of Emergency Service Utilization Patterns in Youth At Risk of Suicide Open
Objective: To explore demographic predictors of Emergency Department (ED) utilization among youth with a history of suicidality.Methods: Electronic health records were extracted for 3,094 8-22 year-old patients with a history of suicidalit…
View article: Development of “CULTURE FORWARD: A strengths and culture-based tool to protect our native youth from suicide”.
Development of “CULTURE FORWARD: A strengths and culture-based tool to protect our native youth from suicide”. Open
CULTURE FORWARD honors and empowers communities by weaving strands of knowledge, stories, and practical resources highlighting Native communities' strengths to protect against Native youth suicide. The guide is free online and print copies…
View article: Centering Indigenous Knowledges and Worldviews: Applying the Indigenist Ecological Systems Model to Youth Mental Health and Wellness Research and Programs
Centering Indigenous Knowledges and Worldviews: Applying the Indigenist Ecological Systems Model to Youth Mental Health and Wellness Research and Programs Open
Globally, Indigenous communities, leaders, mental health providers, and scholars have called for strengths-based approaches to mental health that align with Indigenous and holistic concepts of health and wellness. We applied the Indigenist…
View article: Understanding opioid use within a Southwestern American Indian Reservation Community: A qualitative study
Understanding opioid use within a Southwestern American Indian Reservation Community: A qualitative study Open
Purpose Morbidity and mortality due to nonprescription use of opioids has been well documented following the significant increase in the availability of prescription opioids in the early 2000s. The aim of this paper is to explore community…
View article: Suicide Prevention for American Indian and Alaska Native Youth: Lessons Learned and Implications for Underserved Communities
Suicide Prevention for American Indian and Alaska Native Youth: Lessons Learned and Implications for Underserved Communities Open
This chapter synthesizes data on health disparities in suicide rates and lack of service access and discusses current gaps in research, training, and program implementation for underserved populations. We highlight emerging best practices …
View article: Balancing cultural specificity and generalizability: Brief qualitative methods for selecting, adapting, and developing measures for research with American Indian communities.
Balancing cultural specificity and generalizability: Brief qualitative methods for selecting, adapting, and developing measures for research with American Indian communities. Open
Culturally appropriate, valid and reliable measures are critical to assessing how interventions impact health. There is a tension between measures for specific cultural settings versus more general measures that permit comparisons across s…
View article: A Cascade of Care Model for Suicide Prevention
A Cascade of Care Model for Suicide Prevention Open
The rising rates of suicide in the United States, particularly among young people of color, requires urgent attention. While the healthcare system is a critical service sector for suicide prevention given high levels of utilization by peop…
View article: Community Perspectives on Social Influences on Suicide Within a Native American Reservation
Community Perspectives on Social Influences on Suicide Within a Native American Reservation Open
Relative to the general population, Native Americans (NA) bear a disproportionate burden of suicide-related mortality rates. NA males and females aged 15 to 24 years experience suicide rates nearly 3 times than the U.S. all races rates in …
View article: Suicide Ideation and Depression Quality of Life Ratings in a Reservation-Based Community of Native American Youths and Young Adults
Suicide Ideation and Depression Quality of Life Ratings in a Reservation-Based Community of Native American Youths and Young Adults Open
Suicide among adolescents is a significant public health concern in the U.S., especially within American Indian and Alaska Native (AIAN) communities. Lack of quality of life (QoL) estimates for both suicide ideation and depression specific…
View article: Suicide and the opioid overdose crisis among American Indian and Alaska Natives: a storm on two fronts demanding swift action
Suicide and the opioid overdose crisis among American Indian and Alaska Natives: a storm on two fronts demanding swift action Open
The opioid crisis in the United States has received national attention and critical resources in the past decade. However, what has been overlooked is the effect the opioid crisis may be having on a three-decade suicide crisis among Americ…
View article: Designing a Clinical Decision Support Tool That Leverages Machine Learning for Suicide Risk Prediction: Development Study in Partnership With Native American Care Providers
Designing a Clinical Decision Support Tool That Leverages Machine Learning for Suicide Risk Prediction: Development Study in Partnership With Native American Care Providers Open
Background Machine learning algorithms for suicide risk prediction have been developed with notable improvements in accuracy. Implementing these algorithms to enhance clinical care and reduce suicide has not been well studied. Objective Th…
View article: Empowering our people: Predictors of retention in an STI risk reduction program among rural Native Americans with binge substance use
Empowering our people: Predictors of retention in an STI risk reduction program among rural Native Americans with binge substance use Open
Purpose Substance use and sexual risk‐taking have been shown to co‐occur. Programs focused on sexually transmitted infections (STIs) reduction may benefit substance‐using, particularly binge substance‐using, adults. This is especially true…