Long-term Impact of the Fostering Healthy Futures for Preteens Program on Suicide-Related Thoughts and Behaviors for Youth in Out-of-home Care: A Randomized Controlled Trial

Youth in out-of-home care are at high risk for suicide-related thoughts and behaviors (STB), yet there are no known efficacious interventions that reduce STB for this population. Fostering Healthy Futures for Preteens (FHF-P) is a 9-month community-based mentoring and skills training preventive intervention for children in out-of-home care. A randomized controlled trial enrolled 156 participants aged 9-11 years who were placed in out-of-home care over the prior year. Participants were 48.9% female, 54.1% Hispanic, 30.1% Black, and 27.1% American Indian. Follow-up interviews, conducted 7-12 years postintervention (85.2% retention rate), asked young adult participants, aged 18-22, to self-report lifetime STB as indexed by non-suicidal self-injury, suicidal thoughts, plans, and/or attempts. There was a nonsignificant reduction in the odds of STB for the intervention group at follow-up (OR = 0.74; CI, 0.32, 1.69). However, FHF-P significantly moderated the effect of baseline STB; control youth who reported baseline STB had 10 times the odds of young adult STB (OR = 10.44, CI, 2.28, 47.78), but there was no increase in the odds of adult-reported STB for intervention youth. Findings suggest that FHF-P buffers the impact of pre-existing STB on young adult STB for care-experienced youth. Further research is needed to identify mechanisms that may reduce STB in this population. Fostering Healthy Futures for Preteens (FHF-P) is an intervention for children in out-of-home care. This randomized trial examined whether FHF-P reduced suicide-related thoughts and behaviors (STB). FHF-P demonstrated a nonsignificant 26% reduction in the odds of STB 7-12 years postintervention. An interaction effect suggested that FHF-P buffered the impact of preteen STB on young adult STB.