ORIGINAL RESEARCH article

Front. Public Health

Sec. Public Mental Health

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1616464

This article is part of the Research TopicMultidimensional Approaches to Suicide Prevention: Innovations, Challenges, and Future DirectionsView all 12 articles

Walking the Good Road of Life: a longitudinal evaluation of American Indian youth suicide prevention training

Provisionally accepted
Clayton SmallClayton Small1Ernie Big HornErnie Big Horn2Geri SmallGeri Small3Kellie WebbKellie Webb4Edwina Brown BullEdwina Brown Bull5Maha Charani SmallMaha Charani Small1Ruthie Cedar FaceRuthie Cedar Face5Warren PourierWarren Pourier5Hawkeye MontileauxHawkeye Montileaux5Lance ChristiansenLance Christiansen5Brian BradleyBrian Bradley6Wayne TrottierWayne Trottier7Paola TrottierPaola Trottier7Mike GeboeMike Geboe8Emily R BeamonEmily R Beamon9Bethany FatupaitoBethany Fatupaito9Brighten Crawford-MartinBrighten Crawford-Martin9Yolanda IkazobohYolanda Ikazoboh9Kesiena AbekeKesiena Abeke9Sadie PoseySadie Posey9Kelley MilliganKelley Milligan9Allyson KelleyAllyson Kelley9*
  • 1Native PRIDE, Fleming Island, FL, United States
  • 2Spotted Bull Resource Recovery Center, Poplar, MT, United States
  • 3Boys and Girls Club Northern Cheyenne Nation, Lame Deer, MT, United States
  • 4Doya Natsu Healing Center, Fort Washakie, Wyoming, United States
  • 5Little Wound School, Kyle, SD, United States
  • 6Kayenta Unified School District, Kayenta, AZ, United States
  • 7New Town School District, New Town, ND, United States
  • 8Rocky Boy Tribal Health, Box Elder, MT, United States
  • 9Allyson Kelley and Associates, Sisters, United States

The final, formatted version of the article will be published soon.

Select one of your emails

You have multiple emails registered with Frontiers:

Notify me on publication

Please enter your email address:

If you already have an account, please login

You don't have a Frontiers account ? You can register here

Background: American Indian/Alaska Native (AI/AN) populations have the highest suicide rate in the United States. Research on effective, culturally-centered, multi-level approaches to prevent suicide in AI/AN populations are limited. Methods: This multi-site longitudinal evaluation employed a retrospective pre-posttest design, utilizing a self-report survey administered daily following the training. Daily surveys included four areas related to suicide prevention, holistic wellness, generational knowledge, behavior change, and legacy impacts. The first objective of this study was to explore how the Good Road of Life training impacted participant knowledge regarding suicide and related risk factors while also exploring protective behaviors and impacts from a culturally-centered, strengths-based lens. A second objective was to present a conceptual model grounded in socioecological and transecological theories of GRL for collective healing targeting the individual, family, community, Tribe, and nation to prevent suicide. Results: Between 2019 and 2024, 27 GRL trainings were conducted at 8 Tribal sites in Montana, South Dakota, North Dakota, and Wyoming. Data accumulated across these 27 trainings and 1,810 students represented diverse tribes, locations, and ages. Students were asked to rate different domains of Holistic Wellness: mental (M = 3.25, SD = 1.03), physical (M = 3.33, SD =1.03), spiritual (M = 3.35, SD = 1.05), and emotional (M = 3.17, SD = 1.12). Students rated 17 generational knowledge domains before and after GRL training; all comparisons were significant at p < .001; all differences had moderate or large effect sizes. Middle school students reported larger increases in knowledge from pre to post than high school students. Discussion: Findings from this evaluation underscore the importance of early intervention, culturally-centered approaches, and community-led suicide prevention in AI/AN populations.

Keywords: American Indian / Alaska Native, American Indian youth, suicide prevention, gatekeeper training, Cultural intervention

Received: 22 Apr 2025; Accepted: 05 Jun 2025.

Copyright: © 2025 Small, Big Horn, Small, Webb, Brown Bull, Small, Cedar Face, Pourier, Montileaux, Christiansen, Bradley, Trottier, Trottier, Geboe, Beamon, Fatupaito, Crawford-Martin, Ikazoboh, Abeke, Posey, Milligan and Kelley. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Allyson Kelley, Allyson Kelley and Associates, Sisters, United States

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material