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Bond AE, Rodriguez TR, Bandel SL, Hamilton JL, Boyd SI, Gordon K, Anestis MD. Communicating the science of suicide prevention: A call to action for psychologists. Suicide Life Threat Behav 2024. [PMID: 38984859 DOI: 10.1111/sltb.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION Suicide is a major public health concern within the United States, and prevention efforts are essential for decreasing the suicide rate. Researchers and clinicians have knowledge and effective treatments for preventing suicide; however, their impact is limited to those with access to services. Science Communication (SciComm) is an effective tool that can be integrated into the field of suicide prevention and can bridge the gap between scientific findings and the general population. SciComm can help disseminate evidence-based strategies for suicide prevention, dispel misinformation on suicide, and normalize help-seeking. PURPOSE In this article, we propose specific, tangible ways that SciComm can be integrated into graduate school programs, mentorship, career advancement requirements and can help enact systemic change within the field of suicide prevention. Additionally, we discuss why it is important that the field of suicide prevention, specifically, adopts a SciComm framework. Embracing SciComm can help the field of suicide prevention to have a broader impact and can help to reduce rates of suicide.
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Affiliation(s)
- Allison E Bond
- The New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
| | - Taylor R Rodriguez
- The New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
| | - Shelby L Bandel
- The New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
| | - Jessica L Hamilton
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
| | - Simone I Boyd
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
| | - Kathryn Gordon
- Equip Health, Boston, MA, USA
- North Dakota State University, Fargo, North Dakota, USA
| | - Michael D Anestis
- The New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- Department of Urban-Global Public Health, Rutgers University, New Brunswick, New Jersey, USA
- University of Southern Mississippi - Psychology Hattiesburg, Hattiesburg, Mississippi, USA
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2
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Slay PD, Castille KW, Hong E, Polizzi N, Hoyt T. Enhancing suicide prevention outreach via mobile-enabled website design. Suicide Life Threat Behav 2021; 51:229-236. [PMID: 33876494 DOI: 10.1111/sltb.12698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Online outreach campaigns are a potential public health method for reaching service members at risk for suicide. The Real Warriors Campaign website underwent a full redesign in 2019 to enhance its ability to provide crisis resources and increase engagement by adopting a mobile-first strategy and implementing a responsive framework, meaning the site renders properly on all devices, including desktop, tablets, and mobile. Usability testing with end-user service members led to several innovations on the website, including a one-click banner that directly linked users on their mobile phones to crisis resources, the redesign of menus and content to better display on mobile devices, and promoting use of website resources through gateway topics. Comparing the 6 months before and after the mobile redesign showed significant increases in new mobile users, pages viewed on mobile devices, and new users coming to the site through social media. There was also a significant increase in specific help-seeking actions by users, including use of referral links and live chat, as well as 200 individuals accessing crisis phone lines through new one-click dialing banners. Suicide prevention campaigns should continue to optimize their online presence to reach groups at risk. This study of the website redesign from the Real Warriors Campaign illustrates several best practices in digital outreach as applied to suicide prevention, including leveraging usability testing, synching outreach material with social media, and ensuring mobile compatibility.
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Affiliation(s)
- Patrick D Slay
- Psychological Health Center of Excellence, Defense Health Agency, Silver Spring, MD, USA
| | - Kristina W Castille
- Psychological Health Center of Excellence, Defense Health Agency, Silver Spring, MD, USA
| | - Esther Hong
- Psychological Health Center of Excellence, Defense Health Agency, Silver Spring, MD, USA
| | - Nicholas Polizzi
- Psychological Health Center of Excellence, Defense Health Agency, Silver Spring, MD, USA
| | - Tim Hoyt
- Psychological Health Center of Excellence, Defense Health Agency, Silver Spring, MD, USA
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Teo AR, Marsh HE, Ono SS, Nicolaidis C, Saha S, Dobscha SK. The Importance of "Being There": a Qualitative Study of What Veterans with Depression Want in Social Support. J Gen Intern Med 2020; 35:1954-1962. [PMID: 32076990 PMCID: PMC7352022 DOI: 10.1007/s11606-020-05692-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 01/29/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Social connectedness exerts strong influences on health, including major depression and suicide. A major component of social connectedness is having individual relationships with close supports, romantic partners, and other trusted members of one's social network. OBJECTIVE The objective of this study was to understand how individuals' relationships with close supports might be leveraged to improve outcomes for primary care patients with depression and at risk for suicide. DESIGN In this qualitative study, we used a semi-structured interview guide to probe patient experiences, views, and preferences related to social support. PARTICIPANTS We conducted interviews with 30 primary care patients at a Veterans Health Administration (VA) medical center who had symptoms of major depression and a close support. APPROACH Thematic analysis of qualitative interview data examined close supports' impact on patients. We iteratively developed a codebook, used output from codes to sort data into themes, and selected quotations that exemplified themes for inclusion in this manuscript. KEY RESULTS "Being there" as an important quality of close supports emerged as a key concept. "Being there" was defined in three ways: physical proximity, frequent or responsive contact, or perceived availability. Close supports who were effective at "being there" possessed skills in intuitively sensing the patient's emotional state and communicating indirectly about depression. Three major barriers to involving close supports in depression care were concerns of overburdening the close support, a perception that awareness of the patient's depression would make the close support unnecessarily worried, and a desire and preference among patients to handle depression on their own. CONCLUSIONS "Being there" represents a novel, patient-generated way to conceptualize and talk about social support. Suicide prevention initiatives such as population-level communication campaigns might be improved by incorporating language used by patients and addressing attitudinal barriers to allowing help and involvement of close supports.
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Affiliation(s)
- Alan R Teo
- VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), Portland, OR, USA.
- Department of Psychiatry, Oregon Health & Science University,, Portland, OR, USA.
- Oregon Health & Science University and Portland State University, School of Public Health, Portland, OR, USA.
| | - Heather E Marsh
- VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), Portland, OR, USA
| | - Sarah S Ono
- VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), Portland, OR, USA
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Christina Nicolaidis
- Oregon Health & Science University and Portland State University, School of Public Health, Portland, OR, USA
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
- School of Social Work, Portland State University, Portland, OR, USA
| | - Somnath Saha
- VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), Portland, OR, USA
- Oregon Health & Science University and Portland State University, School of Public Health, Portland, OR, USA
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Steven K Dobscha
- VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University,, Portland, OR, USA
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Karras E, Stokes CM, Warfield SC, Barth SK, Bossarte RM. A randomized controlled trial of public messaging to promote safe firearm storage among U.S. military veterans. Soc Sci Med 2019; 241:112205. [PMID: 31387766 PMCID: PMC7561038 DOI: 10.1016/j.socscimed.2019.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 01/25/2019] [Accepted: 03/01/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND The objectives of this study were to determine whether short-term exposure to firearm safety messaging significantly improved (1) firearm storage practices, and (2) attitudes of safe firearm storage behaviors among U.S. veterans, a group at elevated risk for firearm suicide. DESIGN A three-arm, parallel-group RCT was conducted online in the U.S. nationwide from December 2015 to January 2016. SETTING A national random sample of U.S. veterans (N = 358) was recruited from the GfK KnowledgePanel, a probability-based internet panel representative of U.S. adults. All study activities were administered online over a three-week study period. INTERVENTION Participants were randomized and exposed three times (once per week) to either (a) firearm safety message only (n = 115); (b) firearm safety and mental health promotion messages (n = 133); or (c) active control group exposed to mental health promotion message only (n = 110). Each message was less than two minutes long. MEASURES Assessments were completed at baseline (pre-randomization) and at end-of-trial. Changes in awareness of risk for injuries, attitudes/beliefs related to safe storage practices, behavioral intentions, and storage practices were measured using self-reported surveys. Linear mixed effect models with weighted generalized estimating equations were used to test for exposure effects. Analyses were conducted February 2018. RESULTS Analyses restricted to those with baseline firearm access (n = 195) identified no significant changes for intentions or safe storage practices across exposure groups. At baseline, participants' attitudes and beliefs were generally supportive of safe firearm storage. The Firearm Safety message yielded small increases in agreement with the concept that secure storage is "important during emotional or stressful times" (0.36; 95% CI = 0.08, 0.64). Other significant changes in awareness and beliefs were found, but across all study conditions. CONCLUSION Results reinforce the critical need for considerable research and testing prior to the widespread implementation of public messages to increase the likelihood for desired exposure effects.
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Affiliation(s)
- Elizabeth Karras
- Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua VA, Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; Department of Psychiatry, University of Rochester, Rochester, NY, USA; Injury Control Research Center, West Virginia University, Morgantown, WV, USA.
| | - Cara M Stokes
- Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua VA, Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; Injury Control Research Center, West Virginia University, Morgantown, WV, USA; Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Sara C Warfield
- Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua VA, Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; Injury Control Research Center, West Virginia University, Morgantown, WV, USA; Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Shannon K Barth
- Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua VA, Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; Injury Control Research Center, West Virginia University, Morgantown, WV, USA; Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Robert M Bossarte
- Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua VA, Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; Injury Control Research Center, West Virginia University, Morgantown, WV, USA; Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA; Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV, USA
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Schuman DL, Cerel J, Praetorius RT. Suicide in U.S. Women Veterans: An Interpersonal Theory Perspective on Suicide Prevention Policies. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:418-429. [PMID: 31140383 DOI: 10.1080/19371918.2019.1616028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Increases in suicide rates for U.S. women Service Members and Veterans have emerged as a public health issue of great concern. Women Veterans are more likely than their civilian counterparts to die by suicide, and rates of suicide for women Veterans are rising faster than rates for male Veterans. Given higher rates of suicide in combat-exposed males and increased rates of suicide associated with military deployment for women, the expansion of women into direct combat roles may further escalate their rates of suicide. The interpersonal theory of suicide provides a framework for the examination of women Veterans' risk factors and how implementation of policy provisions can more effectively ameliorate suicide risk. Recent suicide prevention policy initiatives that target women Veterans' unique needs are important steps; however, suicide prevention efforts should address specific risk factors contributing to thwarted belongingness, perceived burdensomeness, and the acquired capability for suicide in Veteran women.
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Affiliation(s)
- Donna L Schuman
- a College of Social Work , University of Kentucky , Lexington , Kentucky , USA
| | - Julie Cerel
- a College of Social Work , University of Kentucky , Lexington , Kentucky , USA
| | - Regina T Praetorius
- b School of Social Work , University of Texas at Arlington , Arlington, TX , USA
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Rhidenour KB, Barrett AK, Blackburn KG. Heroes or Health Victims?: Exploring How the Elite Media Frames Veterans on Veterans Day. HEALTH COMMUNICATION 2019; 34:371-382. [PMID: 29172714 DOI: 10.1080/10410236.2017.1405481] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We examine the frames the elite news media uses to portray veterans on and surrounding Veterans Day 2012, 2013, 2014, and 2015. We use mental health illness and media framing literature to explore how, why, and to what extent Veterans Day news coverage uses different media frames across the four consecutive years. We compiled a Media Coverage Corpora for each year, which contains the quotes and paraphrased remarks used in all veterans news stories for that year. In our primary study, we applied the meaning extraction method (MEM) to extract emergent media frames for Veterans Day 2014 and compiled a word frequency list, which captures the words most commonly used within the corpora. In post hoc analyses, we collected news stories and compiled word frequency lists for Veterans Day 2012, 2013, and 2015. Our findings reveal dissenting frames across 2012, 2013, and 2014 Veterans Day media coverage. Word frequency results suggest the 2012 and 2013 media frames largely celebrate Veterans as heroes, but the 2014 coverage depicts veterans as victimized by their wartime experiences. Furthermore, our results demonstrate how the prevailing 2015 media frames could be a reaction to 2014 frames that portrayed veterans as health victims. We consider the ramifications of this binary portrayal of veterans as either health victims or heroes and discuss the implications of these dueling frames for veterans' access to healthcare resources.
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Affiliation(s)
| | | | - Kate G Blackburn
- b Oak Ridge Institute for Science and Education, Department of Psychology, University of Texas at Austin
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Karras E, Stokes CM, Warfield SC, Elder H, Stephens B, Bossarte RM. The Use of Theory-Based Formative Research to Design Suicide Prevention Messaging for U.S. Veterans in Midlife. HEALTH EDUCATION & BEHAVIOR 2018; 45:1016-1024. [PMID: 29658315 DOI: 10.1177/1090198118769344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Communication campaigns offer a viable mechanism to promote suicide prevention and reinforce mental health for U.S. veterans in midlife, a group with a high suicide burden. However, little empirical investigation of this type of messaging has been conducted, with formative campaign research conspicuously missing from the limited literature. AIMS Using the theory of planned behavior as a guide, formative research was conducted to inform the design of suicide prevention messaging by (a) describing and measuring several theoretical constructs among our audience and (b) modeling associations between constructs and intentions to seek help for suicidal behaviors and mental health more broadly. METHODS Telephone-based cross-sectional surveys were collected between 2014 and 2016 from a nationally representative sample of veterans with analyses restricted to those aged between 44 and 65 years ( n = 809). Multiple logistic regression was used to identify significant factors associated with intentions to seek help for either suicidal behaviors or mental health. RESULTS Perceived behavioral control was one of the largest predictors of intentions to seek help for both suicidal behaviors and mental health concerns. Descriptive norms were also significantly associated with suicide-related intentions. Data further suggest several types of attitudes (i.e., discordant beliefs, stereotypes) to consider when designing messages for this group. DISCUSSION This study represents one of the first efforts to document and describe theoretical constructs and their influence on intentions among veterans in midlife to contribute to the development of evidence-based messaging for veterans informed by a conceptual framework. CONCLUSION Findings have important implications as the use of communication strategies for suicide prevention grows increasingly popular.
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Affiliation(s)
- Elizabeth Karras
- 1 VA Center of Excellence for Suicide Prevention, Canandaigua, NY, USA.,2 University of Rochester, Rochester, NY, USA.,3 West Virginia University, Morgantown, WV, USA
| | - Cara M Stokes
- 1 VA Center of Excellence for Suicide Prevention, Canandaigua, NY, USA.,3 West Virginia University, Morgantown, WV, USA
| | - Sara C Warfield
- 1 VA Center of Excellence for Suicide Prevention, Canandaigua, NY, USA.,3 West Virginia University, Morgantown, WV, USA
| | - Heather Elder
- 4 Massachusetts Department of Public Health, Boston, MA, USA
| | - Brady Stephens
- 1 VA Center of Excellence for Suicide Prevention, Canandaigua, NY, USA
| | - Robert M Bossarte
- 1 VA Center of Excellence for Suicide Prevention, Canandaigua, NY, USA.,3 West Virginia University, Morgantown, WV, USA
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Tan Z, Liu X, Liu X, Cheng Q, Zhu T. Designing Microblog Direct Messages to Engage Social Media Users With Suicide Ideation: Interview and Survey Study on Weibo. J Med Internet Res 2017; 19:e381. [PMID: 29233805 PMCID: PMC5743914 DOI: 10.2196/jmir.8729] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 09/13/2017] [Accepted: 10/05/2017] [Indexed: 12/18/2022] Open
Abstract
Background While Web-based interventions can be efficacious, engaging a target population’s attention remains challenging. We argue that strategies to draw such a population’s attention should be tailored to meet its needs. Increasing user engagement in online suicide intervention development requires feedback from this group to prevent people who have suicide ideation from seeking treatment. Objective The goal of this study was to solicit feedback on the acceptability of the content of messaging from social media users with suicide ideation. To overcome the common concern of lack of engagement in online interventions and to ensure effective learning from the message, this research employs a customized design of both content and length of the message. Methods In study 1, 17 participants suffering from suicide ideation were recruited. The first (n=8) group conversed with a professional suicide intervention doctor about its attitudes and suggestions for a direct message intervention. To ensure the reliability and consistency of the result, an identical interview was conducted for the second group (n=9). Based on the collected data, questionnaires about this intervention were formed. Study 2 recruited 4222 microblog users with suicide ideation via the Internet. Results The results of the group interviews in study 1 yielded little difference regarding the interview results; this difference may relate to the 2 groups’ varied perceptions of direct message design. However, most participants reported that they would be most drawn to an intervention where they knew that the account was reliable. Out of 4222 microblog users, we received responses from 725 with completed questionnaires; 78.62% (570/725) participants were not opposed to online suicide intervention and they valued the link for extra suicide intervention information as long as the account appeared to be trustworthy. Their attitudes toward the intervention and the account were similar to those from study 1, and 3 important elements were found pertaining to the direct message: reliability of account name, brevity of the message, and details of the phone numbers of psychological intervention centers and psychological assessment. Conclusions This paper proposed strategies for engaging target populations in online suicide interventions.
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Affiliation(s)
- Ziying Tan
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Harvard Graduate School of Education, Harvard University, Cambridge, MA, United States
| | - Xingyun Liu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiaoqian Liu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Qijin Cheng
- Hong Kong Jockey Club Center for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Tingshao Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Acosta J, Ramchand R, Becker A. Best Practices for Suicide Prevention Messaging and Evaluating California's "Know the Signs" Media Campaign. CRISIS 2017; 38:287-299. [PMID: 28228062 DOI: 10.1027/0227-5910/a000446] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although communication is a key component of US strategies to prevent suicide and there are a number of marketing campaigns promoting messages that suicide is a preventable public health problem, there has been little evaluation of these campaigns. AIMS The study describes the development of a checklist of best practices for suicide prevention communication campaigns and the use of the checklist to evaluate California's investment in "Know the Signs" (KTS-M), a suicide prevention mass media campaign. METHOD We conducted a literature review and solicited expert feedback to identify best practices and then used the RAND/UCLA appropriateness method to assess whether KTS-M was consistent with the identified best practices. RESULTS Overall, experts agreed that KTS-M adhered to most of the 46 checklist items and suggested that the campaign was among the best suicide prevention media campaigns they had observed. LIMITATIONS The checklist was developed through expert input and literature review and focuses only on media campaigns. CONCLUSION Given the nascent state of the evidence about what makes an effective suicide prevention message and the growing number of campaigns, the checklist of best practices reflects one way of promoting quality in this evolving field. The consistency between the experts' comments and their ratings of KTS-M suggests that the checklist may provide important guidance to inform the development of future campaigns and the evaluation of ongoing campaigns.
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Affiliation(s)
| | | | - Amariah Becker
- 2 Department of Computer Science, Brown University, Providence, RI, USA
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Karras E, Lu N, Elder H, Tu X, Thompson C, Tenhula W, Batten SV, Bossarte RM. Promoting Help Seeking to Veterans. CRISIS 2016; 38:53-62. [PMID: 27561225 DOI: 10.1027/0227-5910/a000418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Few studies have considered different messaging strategies that may augment campaign efficacy to generate help-seeking behaviors among populations at increased risk for suicide, mainly US military veterans. AIMS Findings are presented from the pilot evaluation of the It's Your Call campaign implemented by the Department of Veterans Affairs (VA). Three messaging strategies (with varying intensity and mix of messages) were compared to explore which best promote use of the Veterans Crisis Line (VCL) among veteran populations. METHOD Daily VCL call data were obtained for 10 US cities during 2011-2012 where the campaign was active, and modeled using Poisson regression to identify changes in utilization patterns associated with the implementation of different messaging strategies. RESULTS Significant increases in call rates were only evident during the campaign in communities where mixed messages were disseminated. Further, use of mixed messages yielded greater increases in call rates when compared with the other tested strategies. This was an observational study where identification of causal relationships between variables was limited. CONCLUSION Findings are encouraging as messaging was associated with help seeking, and they provide insights into strategies that may rapidly promote crisis line use. Results also underscore the need for further research on suicide prevention campaigns and dissemination practices.
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Affiliation(s)
- Elizabeth Karras
- 1 VISN 2 Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua VA Medical Center, Canandaigua, NY, USA.,2 Department of Psychiatry, University of Rochester, NY, USA
| | - Naiji Lu
- 3 Department of Biostatistics and Computational Biology, University of Rochester, NY, USA
| | - Heather Elder
- 1 VISN 2 Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua VA Medical Center, Canandaigua, NY, USA.,4 Department of Public Health Sciences, University of Rochester, NY, USA
| | - Xin Tu
- 2 Department of Psychiatry, University of Rochester, NY, USA.,3 Department of Biostatistics and Computational Biology, University of Rochester, NY, USA
| | - Caitlin Thompson
- 5 Suicide Prevention Office, Department of Veterans Affairs, Washington, DC, USA
| | - Wendy Tenhula
- 6 Mental Health Services, Department of Veterans Affairs, Washington, DC, USA
| | - Sonja V Batten
- 6 Mental Health Services, Department of Veterans Affairs, Washington, DC, USA.,7 Booz Allen Hamilton, Washington, DC, USA
| | - Robert M Bossarte
- 1 VISN 2 Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua VA Medical Center, Canandaigua, NY, USA.,5 Suicide Prevention Office, Department of Veterans Affairs, Washington, DC, USA.,8 Injury Control Research Center, West Virginia University, Morgantown, WV, USA.,9 Department of Behavioral Medicine, West Virginia University, Morgantown, WV, USA
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Fulginiti A, Pahwa R, Frey LM, Rice E, Brekke JS. What Factors Influence the Decision to Share Suicidal Thoughts? A Multilevel Social Network Analysis of Disclosure Among Individuals with Serious Mental Illness. Suicide Life Threat Behav 2016; 46:398-412. [PMID: 26511676 DOI: 10.1111/sltb.12224] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 08/17/2015] [Indexed: 11/30/2022]
Abstract
Nondisclosure of suicidal thoughts limits suicide risk management. Consistent with disclosure models for other stigmatized statuses, understanding suicidal disclosure requires accounting for features of the discloser (individual factors) and the discloser-recipient relationship (relational factors). In a sample of 30 adults with schizophrenia, bipolar disorder, or major depressive disorder (Level 2) who nominated 436 social network members (Level 1), we examined disclosure patterns and identified individual and relational correlates of disclosure intent. Most individuals disclosed in the past (77%; n = 23) and all intended on disclosing (100%; n = 30). Disclosure was highly selective, with 14% (n = 62) of network members identified as prior confidants and 23% (n = 99) identified as intended confidants. Multilevel modeling indicated that relational factors were more central to disclosure than individual factors. Network members who were prior confidants and who provided social support were attractive targets for intended disclosure. Our findings suggest that "targeted" gatekeeper training may be a promising strategy and reveal relational characteristics to identify "high-probability confidants."
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Affiliation(s)
- Anthony Fulginiti
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Rohini Pahwa
- Silver School of Social Work, New York University, New York, NY, USA
| | - Laura M Frey
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Eric Rice
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - John S Brekke
- School of Social Work, University of Southern California, Los Angeles, CA, USA
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Klimes-Dougan B, Wright N, Klingbeil DA. Suicide Prevention Public Service Announcements Impact Help-Seeking Attitudes: The Message Makes a Difference. Front Psychiatry 2016; 7:124. [PMID: 27471477 PMCID: PMC4945655 DOI: 10.3389/fpsyt.2016.00124] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/28/2016] [Indexed: 11/13/2022] Open
Abstract
Suicide continues to be one of the most serious public health challenges. Public service announcements (PSAs) are frequently used to address this challenge, but are rarely sufficiently evaluated to determine if they meet the intended goals, or are associated with potential iatrogenic effects. Although it is challenging to assess the relative impact of different PSA modalities, our group previously noted that one billboard message failed to show the same benefits as one TV ad [e.g., Klimes-Dougan and Lee (1)]. The purpose of this study was to extend these findings to test critical aspects of suicide prevention billboard messaging. Although both simulated billboard messages presented had identical supporting messages, we predicted that the more personal billboard message, focused on saving one's life, would cause more favorable help-seeking attitudes than the message focused on suicide. Young adult university students (N = 785) were randomly assigned to one of three conditions; one of two billboard simulations or a TV ad simulation. Help-seeking attitudes, maladaptive coping, and reports of concern and distress were evaluated. The results of this study suggest some relative benefits in endorsement of favorable help-seeking attitudes for one of the billboard conditions - stop depression from taking another life. Although further research is needed to determine what methods will alter the risk for suicide in the population, the results of this study provide a useful first step showing that some billboard messaging may favorably influence help-seeking attitudes.
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Affiliation(s)
| | - Nathan Wright
- State of Minnesota: Department of Public Health , Minneapolis, MN , USA
| | - David A Klingbeil
- Department of Educational Psychology, University of Wisconsin-Milwaukee , Milwaukee, WI , USA
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Petrova M, Wyman PA, Schmeelk-Cone K, Pisani AR. Positive-Themed Suicide Prevention Messages Delivered by Adolescent Peer Leaders: Proximal Impact on Classmates' Coping Attitudes and Perceptions of Adult Support. Suicide Life Threat Behav 2015; 45:651-63. [PMID: 25692382 PMCID: PMC4540682 DOI: 10.1111/sltb.12156] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 12/17/2014] [Indexed: 11/27/2022]
Abstract
Developing science-based communication guidance and positive-themed messages for suicide prevention are important priorities. Drawing on social learning and elaboration likelihood models, we designed and tested two positive-focused presentations by high school peer leaders delivered in the context of a suicide prevention program (Sources of Strength). Thirty-six classrooms in four schools (N = 706 students) were randomized to (1) peer leader modeling of healthy coping, (2) peer leader modeling plus audience involvement to identify trusted adults, or (3) control condition. Students' attitudes and norms were assessed by immediate post-only assessments. Exposure to either presentation enhanced positive coping attitudes and perceptions of adult support. Students who reported suicide ideation in the past 12 months benefited more than nonsuicidal students. Beyond modeling alone, audience involvement modestly enhanced expectations of adult support, congruent with the elaboration likelihood model. Positive peer modeling is a promising alternative to communications focused on negative consequences and directives and may enhance social-interpersonal factors linked to reduced suicidal behaviors.
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Affiliation(s)
- Mariya Petrova
- Department of Psychiatry; University of Rochester School of Medicine and Dentistry; Rochester New York USA
| | - Peter A. Wyman
- Department of Psychiatry; University of Rochester School of Medicine and Dentistry; Rochester New York USA
| | - Karen Schmeelk-Cone
- Department of Psychiatry; University of Rochester School of Medicine and Dentistry; Rochester New York USA
| | - Anthony R. Pisani
- Department of Psychiatry; University of Rochester School of Medicine and Dentistry; Rochester New York USA
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Hays CA, Spiers JA, Paterson B. Opportunities and Constraints in Disseminating Qualitative Research in Web 2.0 Virtual Environments. QUALITATIVE HEALTH RESEARCH 2015; 25:1576-1588. [PMID: 25870449 DOI: 10.1177/1049732315580556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Web 2.0 digital environment is revolutionizing how users communicate and relate to each other, and how information is shared, created, and recreated within user communities. The social media technologies in the Web 2.0 digital ecosystem are fundamentally changing the opportunities and dangers in disseminating qualitative health research. The social changes influenced by digital innovations shift dissemination from passive consumption to user-centered, apomediated cooperative approaches, the features of which are underutilized by many qualitative researchers. We identify opportunities new digital media presents for knowledge dissemination activities including access to wider audiences with few gatekeeper constraints, new perspectives, and symbiotic relationships between researchers and users. We also address some of the challenges in embracing these technologies including lack of control, potential for unethical co-optation of work, and cyberbullying. Finally, we offer solutions to enhance research dissemination in sustainable, ethical, and effective strategies.
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Affiliation(s)
- Charles A Hays
- Thompson Rivers University, Kamloops, British Columbia, Canada
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A Novel Adaptation of Distress Tolerance Skills Training Among Military Veterans: Outcomes in Suicide-Related Events. COGNITIVE AND BEHAVIORAL PRACTICE 2015. [DOI: 10.1016/j.cbpra.2014.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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16
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Conard PL, Armstrong ML, Young C, Hogan LM. Suicide Assessment and Action for Women Veterans. J Psychosoc Nurs Ment Health Serv 2015; 53:33-42. [DOI: 10.3928/02793695-20150320-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 02/25/2015] [Indexed: 11/20/2022]
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Bossarte RM, Karras E, Lu N, Tu X, Stephens B, Draper J, Kemp JE. Associations between the Department of Veterans Affairs' suicide prevention campaign and calls to related crisis lines. Public Health Rep 2015; 129:516-25. [PMID: 25364053 DOI: 10.1177/003335491412900610] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The Transit Authority Suicide Prevention (TASP) campaign was launched by the Department of Veterans Affairs (VA) in a limited number of U.S. cities to promote the use of crisis lines among veterans of military service. METHODS We obtained the daily number of calls to the VCL and National Suicide Prevention Lifeline (NSPL) for six implementation cities (where the campaign was active) and four control cities (where there was no TASP campaign messaging) for a 14-month period. To identify changes in call volume associated with campaign implementation, VCL and NSPL daily call counts for three time periods of equal length (pre-campaign, during campaign, and post-campaign) were modeled using a Poisson log-linear regression with inference based on the generalized estimating equations. RESULTS Statistically significant increases in calls to both the VCL and the NSPL were reported during the TASP campaign in implementation cities, but were not reported in control cities during or following the campaign. Secondary outcome measures were also reported for the VCL and included the percentage of callers who are veterans, and calls resulting in a rescue during the study period. CONCLUSIONS Results from this study reveal some promise for suicide prevention messaging to promote the use of telephone crisis services and contribute to an emerging area of research examining the effects of campaigns on help seeking.
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Affiliation(s)
- Robert M Bossarte
- Department of Veterans Affairs, Office of Public Health, Epidemiology Program, Post-Deployment Health, Washington, DC ; University of Rochester, Department of Psychiatry, Rochester, NY
| | - Elizabeth Karras
- University of Rochester, Department of Psychiatry, Rochester, NY ; Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY
| | - Naiji Lu
- Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY ; University of Rochester, Department of Biostatistics and Computational Biology, Rochester, NY
| | - Xin Tu
- University of Rochester, Department of Psychiatry, Rochester, NY ; Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY ; University of Rochester, Department of Biostatistics and Computational Biology, Rochester, NY
| | - Brady Stephens
- Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY
| | - John Draper
- National Suicide Prevention Lifeline, Link2Health Solutions, Inc., New York, NY
| | - Janet E Kemp
- Department of Veterans Affairs, Suicide Prevention and Community Engagement, Washington, DC
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Karras E, Stephens B, Kemp JE, Bossarte RM. Using media to promote suicide prevention hotlines to Veteran households. Inj Prev 2013; 20:62-5. [DOI: 10.1136/injuryprev-2012-040742] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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