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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 7: Injury Hospitilization

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Strategy. School-Based Multicomponent Educational Programs to Prevent Suicide

Approach. Conduct school-based multicomponent educational programs with curricula focused on increasing knowledge of risk factors and strengthening social support.

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Overview. Studies show that universal, curriculum-based interventions that focus on increasing knowledge of risk factors and strengthening social support appear to be effective in reducing suicide ideation and attempts. Studies also show that introducing “good behavior” concepts at a young age (1st and 2nd grade) can have lasting lifestyle effects into young adulthood.1-4

Evidence. Moderate/Emerging. School-based multicomponent educational programs with curricula focused on increasing knowledge of risk factors and strengthening social support appear to be effective in preventing suicide. Programs based on this strategy are likely to work. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Elementary, middle school, and high school students.

Outcome.  Increased knowledge about suicide risk factors; increased help-seeking behaviors; reduction of suicide ideation and attempts. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM. You may also want to look at evidence that supports educational programs in other NPM topic areas that can be translated to this specific topic area.

Sample ESMs.Using the approach “Conduct school-based multicomponent educational programs with curricula focused on increasing knowledge of risk factors and strengthening social support,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of elementary, middle school, and high school students participating in educational programs to prevent suicide.
  • Number of elementary, middle, and high schools offering educational programs to prevent suicide.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of elementary, middle school, and high school students participating in educational programs to prevent suicide.
  • Percent of elementary, middle, and high schools offering educational programs to prevent suicide.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of elementary, middle school, and high school students participating in educational programs who showed an increase in knowledge after they finished the curriculum.
  • Number of elementary, middle school, and high school students participating in educational programs who reported an increase in help-seeking behaviors.
  • Number of elementary, middle school, and high school students participating in educational programs who reported a reduction of suicide ideation and attempts.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of elementary, middle school, and high school students participating in educational programs who showed an increase in knowledge after they finished the curriculum.
  • Percent of elementary, middle school, and high school students participating in educational programs who reported an increase in help-seeking behaviors.
  • Percent of elementary, middle school, and high school students participating in educational programs who reported a reduction of suicide ideation and attempts.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


References:

1  Cigularov K, Chen PY, Thurber BW, Stallones L. Investigation of the effectiveness of a school-based suicide education program using three methodological approaches. Psychological Services 2008;5: 262–274.

2 King KA, Strunk CM, Sorter MT. Preliminary effectiveness of surviving the Teens® suicide prevention and depression awareness program on adolescents’ suicidality and self-efficacy in performing help-seeking behaviors. Journal of School Health 2011;81: 581–590.

3  Wilcox HC, Kellam SG, Brown CH, et al. The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempts. Drug Alcohol Depend 2008;95(Suppl 1): S60–S73.

4  Wyman PA, Brown CH, LoMurray M, Schmeelk-Cone K, Petrova M, Yu Q, Walsh E, Tu X, Wang W. An outcome evaluation of the Sources of Strength suicide-prevention program delivered by adolescent peer leaders in high schools. American Journal of Public Health 2010;100: 1653–1661.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.