Effectiveness Trial of Youth Suicide Prevention Delivered by Teen Peer Leaders
| Status: | Completed |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 13 - 20 |
| Updated: | 1/6/2017 |
| Start Date: | August 2010 |
| End Date: | June 2016 |
Effectiveness Trial of Suicide Prevention Delivered by Teen Peer Leaders
The purpose of this study is to evaluate the impact of the school-based Sources of Strength
program in reducing suicidal behaviors in the population of high school students and
determine how the program works (mechanisms of change). Sources of Strength trains diverse
high school students as Peer Leaders, who conduct school-wide prevention messaging
activities with ongoing adult mentoring designed to increase positive coping norms and
practices, help-seeking and increase youth-adult connections. Sources of Strength is
expected to enhance school coping practices, increase help-seeking among distressed and
suicidal youth, and reduce the number of students in the population who attempt suicide. A
total of 40 high schools in primarily rural and micropolitan regions of New York State and
North Dakota will participate in this study that uses a randomized wait-listed design.
program in reducing suicidal behaviors in the population of high school students and
determine how the program works (mechanisms of change). Sources of Strength trains diverse
high school students as Peer Leaders, who conduct school-wide prevention messaging
activities with ongoing adult mentoring designed to increase positive coping norms and
practices, help-seeking and increase youth-adult connections. Sources of Strength is
expected to enhance school coping practices, increase help-seeking among distressed and
suicidal youth, and reduce the number of students in the population who attempt suicide. A
total of 40 high schools in primarily rural and micropolitan regions of New York State and
North Dakota will participate in this study that uses a randomized wait-listed design.
Investigators will enroll and conduct this trial with 3-4 separate cohorts of high schools
over five years, allowing the logistical load to be evenly distributed throughout the study
(total 40 schools). Randomization will occur at the school level since Sources of Strength
is a school-wide intervention. In each cohort, schools will be enrolled as pairs from the
same regions in New York State or North Dakota, for a total of six pairs per cohort. One
school from each pair will be randomly assigned to begin training within a few months
(Immediate Intervention) or to a wait-list to receiving training approximately 2 years later
(Wait List). By pairing schools from the same region and state, before they are randomly
assigned to one of the two study conditions, the design reduces the potential for external
events (e.g., suicide of a local celebrity) biasing students' behaviors or self-reports
within one of the conditions, which could affect investigators' ability to evaluate
intervention impact.
The active intervention period in each cohort will span approximately 16 months to test the
impact on the school population of Sources of Strength training and messaging steps over two
school years, which is the optimal time-period for this intervention. Schools assigned to
the Wait List Condition will receive training and begin program implementation in the fall
of the third school year, and investigators will provide those schools with training and
technical assistance to complete the intervention over 16 months, fully comparable to the
early intervention schools.
To assess outcomes of suicide attempts, hypothesized mechanisms of intervention impact
(coping norms and practices, connections with adults and peers), and mental health and
behavioral risk factors, investigators will conduct a baseline and 3 repeated surveys of the
student population in each school using surveys. The investigators have successfully
employed this strategy previously to test Sources of Strength in 12 high schools in New York
and North Dakota and attained high rates of participation, commensurate to or higher than
other studies evaluating screening or other community suicide prevention strategies.
Baseline surveys (B) will be administered to all students in schools in both conditions
before the intervention begins in any school. The next survey administrations will occur at
the end of the first school year (6 months, T1), the beginning of the next school year (12
months, T2), and end of the second school year (18 months, T3). Investigators will provide
full training and support for those cohort 3 control schools to complete their intervention.
In addition, social network data (close friend nominations, trusted adults named) will be
collected across all schools to determine network mediators of intervention effects.
over five years, allowing the logistical load to be evenly distributed throughout the study
(total 40 schools). Randomization will occur at the school level since Sources of Strength
is a school-wide intervention. In each cohort, schools will be enrolled as pairs from the
same regions in New York State or North Dakota, for a total of six pairs per cohort. One
school from each pair will be randomly assigned to begin training within a few months
(Immediate Intervention) or to a wait-list to receiving training approximately 2 years later
(Wait List). By pairing schools from the same region and state, before they are randomly
assigned to one of the two study conditions, the design reduces the potential for external
events (e.g., suicide of a local celebrity) biasing students' behaviors or self-reports
within one of the conditions, which could affect investigators' ability to evaluate
intervention impact.
The active intervention period in each cohort will span approximately 16 months to test the
impact on the school population of Sources of Strength training and messaging steps over two
school years, which is the optimal time-period for this intervention. Schools assigned to
the Wait List Condition will receive training and begin program implementation in the fall
of the third school year, and investigators will provide those schools with training and
technical assistance to complete the intervention over 16 months, fully comparable to the
early intervention schools.
To assess outcomes of suicide attempts, hypothesized mechanisms of intervention impact
(coping norms and practices, connections with adults and peers), and mental health and
behavioral risk factors, investigators will conduct a baseline and 3 repeated surveys of the
student population in each school using surveys. The investigators have successfully
employed this strategy previously to test Sources of Strength in 12 high schools in New York
and North Dakota and attained high rates of participation, commensurate to or higher than
other studies evaluating screening or other community suicide prevention strategies.
Baseline surveys (B) will be administered to all students in schools in both conditions
before the intervention begins in any school. The next survey administrations will occur at
the end of the first school year (6 months, T1), the beginning of the next school year (12
months, T2), and end of the second school year (18 months, T3). Investigators will provide
full training and support for those cohort 3 control schools to complete their intervention.
In addition, social network data (close friend nominations, trusted adults named) will be
collected across all schools to determine network mediators of intervention effects.
Inclusion Criteria:
- currently enrolled high school students
Exclusion Criteria:
- below 7th grade reading level in English
- parent declines permission
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