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

Abstract 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.