Community Partner Perspectives on Implementation Determinants of a Strengths-Based, Trauma-Informed School Suicide Prevention Intervention

AI Summary

Insufficient school resources impede implementation of SAFETY-A, especially in under-resourced districts serving predominantly minoritised immigrant families.
Historical system over-involvement with communities of colour fosters learned mistrust, undermining acceptability and engagement with suicide prevention efforts.
Cultural and linguistic differences create barriers to family engagement; strategies must address HEIF-identified determinants to promote equitable SAFETY-A implementation.

Implement Res Pract. 2026 May 4;7:26334895261438503. doi: 10.1177/26334895261438503. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND: Research has revealed persistent disparities in meeting the needs of racially minoritized youth identified with suicide risk in schools. An evidence-based trauma-informed suicide prevention practice, such as SAFETY-A (Safe Alternatives for Teens and Youth-Acute), may reduce unmet need and promote equitable care outcomes. Yet, it is highly challenging to implement practice innovations in under-resourced non-specialty settings, such as schools.

METHOD: We conducted a multi-level assessment of barriers to implementing SAFETY-A in school districts serving predominantly immigrant families of color. School-based providers (N = 17) and caregivers and students (N = 10) were interviewed about their perceptions of the feasibility and acceptability of SAFETY-A within their school and community context. Immersion and crystallization analytical methods were used to identify implementation barriers that align with the Health Equity Implementation Framework (HEIF).

RESULTS: Eleven themes were identified across multiple determinant levels. Findings show that implementation barriers are interrelated across determinant levels. Major barriers were related to the lack of resources in schools; the historical context of system over-involvement with communities of color that contribute to (l)earned mistrust; and cultural and linguistic differences working with families.

CONCLUSIONS: Results aligned with HEIF domains implicated in maintaining health disparities. Implementation strategies for SAFETY-A in schools should be responsive to these determinants of disparities.

PMID:42117014 | PMC:PMC13157536 | DOI:10.1177/26334895261438503

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