Abstract
Suicide prevention training programs have spread rapidly within child and public-serving organizations, due to the alarming increase in youth suicide rates. Yet, within these organizations, roles and responsibilities can shape attitudes and intentions related to suicide prevention, thereby influencing the uptake of prevention efforts. As such, various organizational and individual factors can predict uptake, adoption, and maintenance of prevention efforts (Fixsen et al., 2005). To date, few studies have examined the service delivery context in understanding training effectiveness, especially as it relates to QPR (Question Persuade and Refer), one of the most widely disseminated suicide prevention gatekeeper programs. The purpose of this longitudinal study was to evaluate whether individual and organizational characteristics influenced the effectiveness and sustainability of training outcomes, and whether such differences existed among diverse child and public-serving delivery sectors. Several training outcomes that align with the Theory of Planned Behavior (Ajzen, 1991) were examined, including confidence, attitudes, social norms, and suicide prevention behaviors. Measures were assessed prior to and 90 days after the QPR program among a sample of 858 professionals. Community support personnel uniquely showed improvements on social norms while juvenile justice and child welfare workers engaged in more suicide prevention behaviors post training. While trainees across sectors had improved suicide prevention attitudes, law enforcement personnel were the exception. Organizational climate predicted change in suicide prevention attitudes, confidence, and social norms. Trainees who were older, Latinx, and Black had the most improvement on several training outcome variables, but these findings also varied within service sectors.
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Notes
We compared the individual and organizational characteristics from the pretest survey across participants with and without valid data at all three time points. No meaningful differences were observed across sex, race/ethnicity, age, or organizational climate (i.e., effect size less than 0.05). A larger proportion of participants that completed a follow-up survey earned a college degree (i.e., bachelors or higher, Cramer’s V = 0.09, p < .001).
Only 0.1% of participants identified with a gender other than male or female.
Since 32% of participants reported no interaction with youth in the past 3 months at one or both time points, the analyses for this outcome are limited to 584 respondents who reported at least one interaction with a youth in the past 3 months at both time points.
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This project was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA, Award # 1U79SM060427). The views expressed in this paper do not necessarily reflect the views, opinions, policies, or endorsement of SAMHSA, the Department of Health and Human Services, or the U.S. Government. The authors declare they have no financial interests.
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Gryglewicz, K., Garrison, C.M.T., Childs, K.K. et al. Examining Individual and Service Delivery Context Variables and Their Association with the Effectiveness of QPR Suicide Prevention Gatekeeper Training. Adm Policy Ment Health 51, 47–59 (2024). https://doi.org/10.1007/s10488-023-01308-4
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DOI: https://doi.org/10.1007/s10488-023-01308-4