Suicide prevention in the dot com era: technological aspects of a university suicide prevention program

Western Michigan University's Suicide Prevention Program utilizes multiple technological components, including an online training course, a Web site, and 2 social networking Web site profiles, as integral aspects of a comprehensive program. This article discusses the development, maintenance, use, and impact of the technological aspects of this program, which complement other program activities in meeting program goals. The Web site and use of social networking Web sites have been very well received by members of the university and wider community. Although initial outcomes of each component are positive, low participation in the online training course has limited the usefulness of pretest-posttest comparisons. It is thought that other campus suicide prevention programs may benefit from using technology as a primary method in their suicide prevention programming efforts.     

The Impact of Experiential Exercises on Communication and Relational Skills in a Suicide Prevention Gatekeeper-Training Program for College Resident Advisors

Abstract

Objective: In an effort to identify students at risk for suicide, many colleges are implementing suicide prevention training for campus gatekeepers. This study evaluated the efficacy of a 3-hour, experiential-based gatekeeper training that included an emphasis on enhancing communication skills and relational connection in addition to the didactic foci of standard gatekeeper training. Participants: Sixty-five college student resident advisors (RAs) were trained with Campus Connect. Methods: The training was dismantled to examine the specific contribution of experiential exercises on training outcomes. Results: Compared to didactic training alone, following participation in experiential exercises RAs’ training outcome scores exhibited additional improvement on the Suicide Intervention Response Inventory–2 and a 14-item self-report measure of self-efficacy for specific suicide- and crisis-related knowledge and skills. Conclusions: In gatekeeper training, experiential exercises emphasizing awareness and empathic responding and practice of these skills contribute to an improvement in crisis response skills above and beyond that of didactic training alone.     

Suicide prevention on college campuses: What works and what are the existing gaps? A systematic review and meta-analysis

Abstract

Objective: To examine the effects of universal and targeted suicide prevention programs on relevant outcomes in college campuses. Methods: College suicide prevention programs published from 2009 to 2018 were assessed on outcomes including knowledge, skills, self-efficacy, suicidal ideation, and suicidal behaviors. Effects of the interventions on outcome variables with sufficient studies to warrant meta-analysis (ie, knowledge, skills, and self-efficacy) were meta-analyzed. Studies reporting on the remaining outcomes (ie, suicidal ideation and behaviors) were systematically reviewed. Results: Significant increases in suicide prevention knowledge, skills, and self-efficacy were observed in universal prevention interventions that typically employed gatekeeper prevention strategies. Evidence of reductions in suicidal ideation and behaviors was observed across targeted suicide prevention programs for at-risk students. Conclusion: Prevention programs are beneficial for training those likely to come in contact with people endorsing suicidality, but further research is needed to show that suicide interventions can consistently have significant effects on suicidal students as well.     

Sexual Abuse Prevention Mobile Application (SAP_MobAPP) for Primary School Children in Korea

ABSTRACT

This study aimed to develop and evaluate the effects of a sexual abuse prevention mobile application, SAP_MobAPP, for primary school children. Forty-five subjects were trained for 40 minutes once a week. The experimental group received education that utilized the SAP_MobAPP. Control group A received Web based sexual abuse prevention education, while control group B received textbook based sexual abuse prevention education. Effectiveness was verified through a survey on child sexual abuse recognition and avoidance skills administered before and after training. The SAP_MobAPP program improved recognition (awareness) and the child’s skills to avoid child sexual abuse situations, and the effects were long-lasting. However, differences between groups were not statistically significant. This study developed a sexual abuse prevention application and verified its effectiveness. Awareness and skills to avoid child sexual abuse after app education increased immediately after training and four weeks later. The SAP_MobAPP could be used for sexual abuse prevention education in schools.     

Suicide intervention training for college staff: Program evaluation and intervention skill measurement

Objective: Suicide remains a pressing issue for college communities. Consequently, gatekeeper trainings are often provided for staff. This study examines the effect of one such program, Applied Suicide Intervention Skills Training (ASIST). Participants: 51 college employees received ASIST in August of 2014 and were compared to 30 wait-list control participants. Methods: Repeated Measures ANOVA were used to analyze pre- and post-training: (a) skills at responding to students-at-risk; (b) attitudes toward suicide; (c) knowledge about suicide; and (d) comfort/competence/confidence at helping a student-at-risk. Results: Significant positive training effects were observed for ASIST on self-report measures and also for objectively assessed skill at responding, after adjusting for a potential scoring limitation of the Suicide Intervention Response Inventory, Revised (SIRI-2). Conclusions: ASIST improved the self-perception of college staff at working with students-at-risk of suicide and also their skills at performing an intervention. Further, analysis of SIRI-2 data provides support for a potential instrument revision.     

Implementing an Early Intervention Program for Residential Students Who Present With Suicide Risk: A Case Study

Abstract

Objective: This case study examined the effects of an early intervention program designed to respond to residential college students demonstrating risk for suicide. Participants: Participants were 108 undergraduates at a large northeastern public university referred to an early intervention program subsequent to presenting with risk factors for suicide between Fall 2004 and Spring 2011. Methods: Data were collected from archival records to examine quality of early intervention services, student retention, and grade point average (GPA) during the semesters prior to, during, and subsequent to the referral incident. Results: Program implementation was timely and responsive to student needs; students successfully completing the early intervention program remained in school and demonstrated small but significant rebounds in GPA the semester subsequent to the incident. Conclusions: There are benefits associated with the implementation of early intervention programs designed to respond to students manifesting risk for suicide, such as connecting the student to vital services and support networks.     

Development,Implementation, and Evaluation of a Comprehensive Course on Suicide in a Master’s of Social Work Program

ABSTRACT

Most master of social work (MSW) programs provide minimal education or training on suicide prevention, intervention, and postvention despite that the majority of social workers encounter suicidal clients during their professional careers. This study describes the development, implementation, and evaluation of a course on suicide in an MSW program. Changes in student suicide-related knowledge, confidence, and preparedness were evaluated using a pre/post design. We found statistically significant increases in knowledge (t [df = 21] = 4.79; p < .001), confidence (t [df = 17] = 8.55; p < .001), and preparedness (t [df = 20] = 7.28; p < .001) from pretest to posttest. Knowledge, confidence, and preparedness were significantly positively correlated, indicating that confidence and preparedness did not increase without a corresponding increase in knowledge. Given the prevalence of suicide and the frequency with which social workers serve populations affected by suicide, it is critical that MSW programs provide effective training on understanding suicide.     

Issues in the Evaluation of an Online Prevention Exercise

ABSTRACT

The rapid growth of computer and Internet technologies and their acceptance as a viable medium for human services delivery has opened up new possibilities for providing effective prevention programming. This article reviews some of the major online prevention websites and evaluations of their effectiveness. In addition, it reports the struggle to evaluate an interactive multimedia anger management exercise that is part of a teen substance abuse prevention website. The evaluation provided some support that a 30-minute exposure to a web-guided prevention exercise could increase teens' prevention knowledge and that completing the online exercise as supplemental homework reinforces the classroom experience. However, positive changes in other measures of behavior change were not supported. The study pointed to many issues that occur when developing and evaluating online interventions in real-world environments.

This background section presents the advantages of online prevention, a brief overview of prevention research and its advantages, and an overview of prevention websites and their evaluation.     

Acculturation Status and Substance Use Prevention with Mexican and Mexican-American Youth

SUMMARY

This study examined whether language preference, as an indicator of acculturation, moderated the effects of a culturally grounded substance use prevention intervention for Mexican and Mexican American middle school students (N = 2,146) in Phoenix, Arizona. The main hypothesis was that levels of program effectiveness would vary based on the language preference of the students and the specific culturally grounded version of the intervention they were assigned. Findings show that matching language preference to particular versions of the intervention did not influence substance use related program outcomes, but that overall program effects (intervention versus control) did vary by language preference. English-language dominant participants, the most at risk sub-group, responded more positively to the intervention, while Spanish dominant, who had low substance use rates at baseline, and bilingual participants did not demonstrate significant differences between the intervention and control groups. Implications for school social work prevention interventions and prevention science in general, are discussed.     

‘Only Connect’: Unifying the social in social work and social media

‘Only Connect…live in fragments no longer’

(E.M. Forster, Howards End).

This paper utilises ‘Only Connect’, the epigraph from Forster’s novel ‘Howards End’ as the starting point for exploring the challenges and opportunities of integrating social networking with relationship based social work practice. The paper discusses the more deleterious implications of social networking, whilst assuming a deliberately optimistic stance to uncover ways in which the opportunities afforded by online space can be utilised effectively within social work education and practice. Whilst recognising that social networking platforms are transforming constantly, the paper adopts Kaplan’s definition of social media as a ‘group of internet based applications that build on the ideological and technological foundations of Web 2.0’. Whilst much of the discussion within the paper relates to Twitter and Facebook, two of the most endemic international social networking platforms, it is also applicable to myriad forms of social networking. The paper begins with a discussion of UK professional conduct cases and explores these both within Klein’s concept of splitting and historical attitudes to new technologies. Drawing from emerging research data and other examples, the positive relational practices educed by social media within social work education and practice are emphasised and discussed. The paper concludes by highlighting Forster’s plea for connection and recommending that social work embraces the renewed opportunities provided by online networking.     

My Student Body: Effects of an Internet-Based Prevention Program to Decrease Obesity Among College Students

Abstract

Objective: To determine the impact of My Student Body (MSB)–Nutrition, an Internet-based obesity prevention program for college students. Participants: Three hundred and twenty ethnically diverse undergraduate students were randomly assigned to 1 of 3 conditions: MSB-Nutrition program, an on-campus weight management course, and a comparison group. Methods: Students completed baseline and follow-up surveys regarding their nutrition and physical activity behaviors, self-efficacy, stress, attitudes, and body weight. Results: Compared with the on-campus course and a comparison group, the MSB-Nutrition program increased fruit and vegetable consumption, reduced stress, and increased fruit and vegetable self-efficacy but had no significant effect on students’ exercise self-efficacy, exercise behavior, or weight loss. Conclusions: The MSB-Nutrition program was effective in changing students’ nutrition behaviors but had no effect on physical activity behaviors or weight loss. Suggestions for improving Internet-based interventions aimed at decreasing obesity rates among college students are offered.     

Suicide and Religion: A Comparative Analysis

Abstract

Previous work on the relationship between religion and suicide has focused on the simple bivariate relationship and has failed to address the problem of the possible convergence between Catholicism and Protestantism in the underlying determinant of suicide, the degree of social integration. The present study explores the relationship more systematically through a series of multiple regression analyses. The lack of any significant relationship between the proportion Catholic and measures of the suicide rate supports the convergence hypothesis. In contrast, two control variables taken from other prominent theories of suicide have considerable explanatory power. Tests of Durkheim's theory of marital integration and suicide all confirm a significant relationship but one of a parabolic form. Finally, the paradigm connecting the level of industrialization to suicide is confirmed, but preliminary analysis of social mobility rates and suicide indicate that this relationship is more of a function of cultural heterogeneity produced by the modernization process than of increasing mobility rates.     

Personal and Professional Knowledge of and Experience With Suicide and Suicide Prevention Among Stakeholders in Clinical and Community Practice

Community-dwelling veterans at risk for suicide may be in contact with a variety of providers in agency-based settings that offer health and human services. The study aim is to describe the perspective of agency-based clinical and community providers who may come into contact with veterans in need of suicide prevention services and to examine the nature of their personal and professional relationships to individuals at risk for suicide among this sample.

This study reports on qualitative data from a sample of Veterans’ Affairs (VA) and community providers serving veterans and military families in one Midwestern state (N = 70). Providers completed a survey assessing exposure to suicide, including contact with and relationship to someone suicidal, and organizational characteristics of the providers’ employing agencies. Semi-structured interview questions probed for the nature of how they would react with suicidal individuals. Most providers (94%) had some prior contact with someone who was suicidal, and nearly three quarters (77%) knew someone who had died by suicide. Providers reported powerful emotional responses of sadness and remorse to suicidal experiences. While these providers interact with veterans and military families as part of their jobs, they may have their own history of being exposed to suicide, both professionally and personally.     

Evaluation of an avatar-based training program to promote suicide prevention awareness in a college setting

Objective: Training programs exist that prepare college students, faculty, and staff to identify and support students potentially at risk for suicide. Kognito is an online program that trains users through simulated interactions with virtual humans. This study evaluated Kognito's effectiveness in preparing users to intervene with at-risk students. Participants: Training was completed by 2,727 university students, faculty, and staff from April, 2014 through September, 2015. Methods: Voluntary and mandatory participants at a land-grant university completed Kognito modules designed for higher education, along with pre- and post-assessments. Results: All modules produced significant gains in reported Preparedness, Likelihood, and Self-Efficacy in intervening with troubled students. Despite initial disparities in reported abilities, after training participants reported being similarly capable of assisting at-risk students, including LGBTQ and veteran students. Conclusions: Kognito training appears to be effective, on a large scale, in educating users to act in a facilitative role for at-risk college students.     

Effectiveness of a Web-based Alcohol-Misuse and Harm-Prevention Course Among High- and Low-Risk Students

Objective: In the current study, the authors assessed whether a new online alcohol-misuse prevention course (College Alc) is more effective at reducing alcohol use and related consequences among drinkers and nondrinkers. Participants: The authors compared incoming college freshmen who reported any past 30-day alcohol use before the beginning of the semester with those who did not. Method Summary: The authors randomly assigned students who completed a precollege baseline survey to either complete a 3-hour noncredit version of College Alc or serve as members of a control group. The authors conducted a follow-up survey 3 months later. Results: Findings indicated that among freshmen who were regular drinkers before college, College Alc appeared to reduce the frequency of heavy drinking, drunkenness, and negative alcohol-related consequences. Among freshmen who did not report any past-30-day alcohol use before college, College Alc did not appear to have any beneficial effects. Conclusions: Results suggest that College Alc may be an effective program for students with a history of alcohol use.     

Knowledge of Suicide Risk Factors,But Not Suicide Ideation Severity,Is Greater Among College Students Who Viewed 13 Reasons Why

Abstract

Objective: To test associations between viewing 13 Reasons Why, Season 1 and past week suicide ideation severity, behavior risk, stigma, and knowledge in college students. To explore whether personal exposure to suicide and depressive symptom severity moderated these associations. Participants: Eight-hundred and eighteen college students, 64% (n?=?522) of whom watched 13 Reasons Why. Methods: Students completed surveys online. Multivariate negative binomial regressions were used to test associations between watching 13 Reasons Why and suicide-related variables, and interaction terms. Results: Suicide ideation severity and suicide behavior risk were not significantly associated with viewing 13 Reasons Why; however, there was limited statistical power to detect associations. The association between watching 13 Reasons Why and greater suicide knowledge was stronger among those who did not have personal exposure to suicide. Conclusions: 13 Reasons Why may be a platform for psychoeducation on suicide, particularly among those who do not have personal exposure.     

Prevention Efforts Underlying Decreases in Binge Drinking at Institutions of Higher Education

Abstract

Analyses of 94 Fund for the Improvement of Post-Secondary Education (FIPSE)-sponsored drug-prevention programs and their outcomes used the Core Survey to identify 34 institutions where college students' binge drinking increased (M = 5.44%) and 60 institutions where it decreased (M = -4.59%) during 2 years of program operation. The authors used an inductively derived taxonomy of prevention program elements, student variables, student substance use, use-related variables, and institutional variables to compare the 2 groups of institutions. Only prevention program elements discriminated between groups. Factor analysis of discriminating elements identified 8 prevention factors that improved base-rate prediction of institutional decrease in binge drinking by 28.1%. Factor synthesis yielded a 3-construct binge-drinking prevention model based on student participation and involvement strategies, educational and informational processes, and campus regulatory and physical change efforts. This model improved base-rate prediction of decreased binge drinking by 33.2%.     

Suicide prevention and community-level indictors

This study sought to develop a set of easily obtainable, relevant measures of a community's condition that could be used to guide its suicide prevention efforts. Existing data were gathered across 159 Georgia counties for nine potential social indicators (rates of net migration, divorce, unemployment, violent crimes reported, driving under the influence of alcohol or drugs [DUI] crashes, high school dropouts, Temporary Assistance for Needy Families [TANF], percentage of population aged 65 or older, and percentage of population who are white males) that had been chosen by the communities. Data on the social indicators from 1995 through 1999 were averaged and analyzed to determine their correlation with aggregated 5-year county suicide rates. Results of multivariate modeling procedures showed number of DUI crashes and percentage of the population aged 65 or older to be significant correlates of the suicide rate, controlling for other potential indicators. These preliminary data may provide a useful model of a county's 5-year suicide rate among counties reporting 20 or more suicides. Research with additional indicators and in other states will help determine the generalizability of these findings to other communities.     

Combining Primary Prevention and Risk Reduction Approaches in Sexual Assault Protection Programming

Abstract

Objective: The object of this study is to extend prior evaluations of Elemental, a sexual assault protection program that combines primary prevention and risk reduction strategies within a single program. Participants and Methods: During 2012 and 2013, program group and control group students completed pretest, posttest, and 6-week and 6-month follow-up surveys assessing sexual attitudes and knowledge as well as experiences with assault. Results: The results reinforce previous findings that Elemental is effective in reducing sexual assault risk. Program effects were both direct, in that participation was associated with lower risk of assault, and mediated, in that participation impacted attitudes and beliefs that are empirically linked to risk of later assault. Conclusions: By combining both primary prevention and risk reduction approaches, Elemental is not only effective at reducing incidences of assault, it is also consistent with a number of recent recommendations for directions in sexual assault prevention programming.